Credentialing Specialist

We are looking for experienced Credentialing & Enrollment Specialists who have experience in the end-to-end process of Provider Enrollments / Insurance Credentialing, Provider Contracting, and Re-Credentialing.

About the Role

Specialists applying for this role must be extremely comfortable working remotely and be willing to make extra efforts to communicate / engage with our credentialing team and clients as well as be able to ensure client work packages are completed flawlessly. This position requires complex levels of organizational skills and the ability to complete assigned tasks within the allotted time to do so.

Responsibilities

• Minimum of 2 years’ experience in provider credentialing and enrollment
• Must have expertise in filing Letters of Interest, enrollment applications from all states, and engaging with payers via calls and / or emails, as well as ensuring conclusions for both individual and group application types.
• Must have a working knowledge of documents required for both individual and group applications and the ability to submit them flawlessly for private commercial, Medicare, and Medicaid payors as well as Medicaid MCO and Medicare supplement / replacement plans.
• Must have the ability to engage with clients, keeping them updated on a regular basis and also ensuring maintenance of active status with payers.
• End-to-end working knowledge of creating and maintaining provider details on CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.
• Be able to apply for and renew as needed all provider licenses; Professional, DEA, Controlled Substance, etc.
• Ensure client and application data is updated and maintained continuously to share with clients when needed at a moment's notice.