Credentialing and Enrollment Specialist (Remote)

Job Description

The Credentialing & Enrollment Specialist facilitates and manages the credentialing and enrollment process from start to finish. This role requires a variety of tasks such as enrolling new providers, maintaining CAQH profiles, auditing payer directories, and adhering to HIPAA guidelines. It also involves daily communication with different parties including payers, internal teams, and providers.

Responsibilities:

• Enroll and revalidate providers with payers
• Submit enrollment applications
• Ensure timely application processing
• follow up on application processing
• Update provider information in databases
• Manage CAQH profiles and facilitate re-attestations
• Collaborate with teams and customers
• Adhere to HIPAA guidelines
• Audit and update payer directories
• Verify enrollment status and instructions
• Maintain provider information in databases
  
  

Qualifications:

Experience:

• 2-4 years in credentialing
• Healthcare sector experience
• Customer Service and Revenue Cycle Management experience
• Proficiency in CAQH, NPPES, and PECOS
  
  

Skills:

• Task-oriented with strong attention to detail
• Excellent in documentation and communication
• Ability to prioritize, manage time, and work effectively both individually and in a team
  
  

Traits:

• Persistent, unafraid to ask questions
  
  

Benefits:

• 401(k)
• 401(k) matching
• Health insurance
• Dental insurance
• Vision insurance
• Disability insurance
• Life insurance
• Flexible spending account
• Employee assistance program
• Flexible schedule
• Paid time-off
  
  

Schedule: Dayshift (remote based)