What are the responsibilities and job description for the Provider Enrollment Credentialing Specialist position at Upstream Rehabilitation?
Job Description
Upstream Rehabilitation, is looking for a Provider Enrollment Credentialing Specialist to join our team
JOB SUMMARY{{:}}
The Provider Enrollment Credentialing Specialist position oversees and responds to group, location and provider enrollment with health plans, including Medicare, Medicaid and other governmental entities. The position will also be responsible for the day-to-day needs of provider enrollment for group, location and individual providers. This position is responsible for supporting the mission, vision and values of Upstream Rehabilitation
.JOB RESPONSIBILITIES{{:
ily.Click Here To Learn Even More About Upst
reamUpstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.
Upstream Rehabilitation, is looking for a Provider Enrollment Credentialing Specialist to join our team
JOB SUMMARY{{:}}
The Provider Enrollment Credentialing Specialist position oversees and responds to group, location and provider enrollment with health plans, including Medicare, Medicaid and other governmental entities. The position will also be responsible for the day-to-day needs of provider enrollment for group, location and individual providers. This position is responsible for supporting the mission, vision and values of Upstream Rehabilitation
.JOB RESPONSIBILITIES{{:
- }}Maintain timely and accurate data entry and periodically revise practitioner data in the credentialing database OneAp
- p.Maintain practitioner paper and electronic data files for practitione
- rsUse the CAQH system to submit practitioner data as required by some client health plans to credential individual practitioner
- s.Initial setup and/or maintenance of approved participating online payer system
- s.Completes provider credentialing and re-credentialing application
- s.Monitors applications and follows-up as needed to ensure enrollment with contracted health plan
- s.Maintains copies of current state licenses and any other required credentialing documents for all assigned provider
- s.Collaborate with HR to facilitate onboarding for all practitioner
- s.Communicate with field & therapist during the credentialing process and respond to field inquires in relation to credentialing reques
- t.Communicate with payers for necessary updates and processe
- s.Uphold Federal & State regulations in regards to credentialing & licensing of clinicians’ agencie
- s.This position may cross-train to perform tasks from other position
- :}}High school diploma or equivalent experien
- ce.Prior experience in Medical Credentialing Process and Revenue cyc
- le.Attention to detail, self-motivated and the ability to communicate effective
- ly.Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organizati
- on.Proficient use of Microsoft Office applications (Word, Excel, Adobe) and internet resourc
- es.Ability to organize and prioritize work and manage multiple priorities and deadlin
- {:}}Annual paid Charity Day to give back to a cause meaningful to
- youMedical, Dental, Vision, Life, Short-Term and Long-Term Disability Insur
- ance3-week Paid Time Off plus paid holi
- days401K company m
ily.Click Here To Learn Even More About Upst
reamUpstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.
