Enrollment & Credentialing Specialist for Medical Billing

Enrollment & Credentialing Specialist for Healthcare

Expanding Team looking for an experienced Healthcare Enrollment & Credential Specialist. Team is responsible for Government and Commercial Payer credentialing and enrollment. Members of this team may assist clients with facility credentialing applications. They have direct and continual contact with clients, insurance representatives and internal staff to ensure all credentialing and enrollment requirements are satisfied to avoid in claim processing.

Responsibilities

This position is responsible for managing and directing the processes of the team to ensure the appropriate processes are in place to monitor and maintain systematic, timely credentialing and re-credentialing with various payer organizations and agencies across multiple states.

Maintain working knowledge of enrollment requirements for various payers and agencies and communicate knowledge with internal teams.

Implement and Manage credentialing software program.

Assist with the credentialing and/or contract processes.

EFT and ERA Enrollment as part of the enrollment process.

Communicate enrollment statuses with internal teams, upper management and clients. Work directly with revenue cycle billing managers to ensure timely filing and resolution of medical claims.

Requirements

Any combination of education and work experience that would provide the required knowledge and abilities.

Proven ability to maintain a large workload and meet deadlines.

Experience with credentialing software, such as OneApp.

Self-motivated individual who can work independently, taking ownership of processes, with a strong desire to learn.

Excellent communication skills, both verbal and written.