Provider Enrollment / Credentialing Specialist at Growing Healthcare Services Company

• Prepare, submit and follow up on all initial payer, re-credentialing applications and revalidation requests for providers and office locations
• Ensure credentialing and licensing processes are completed and notifications sent timely
• Review provider credentialing files and work with providers to obtain the necessary missing, incomplete and expiring items
• Track current status of applications, follow up as necessary and document activity in an accurate and timely manner
• Maintain and update provider files and rosters including but not limited to: internal provider and/or location data, individual CAQH profiles, payer databases, NPI database and Medicare database, and any other as needed
• Maintains records of corporate provider contract files
• Maintain consistent contact with providers to ensure that timelines and expectations are clear and requirements are completed timely
• Advises management team and clients of any potential delays in a providers’ credentialing and works with billing operations staff in resolving billing issues related to payer credentialing issues
• Establish and maintain professional relationship with client contacts, insurance providers, and billing operations staff
• Stays abreast of current health plan and agency requirements for credentialing providers

Education, Training and Skills Required:

• High School Diploma or equivalency certificate
• 2+ years related credentialing experience desired
• Knowledge of medical billing and insurance terminology highly desirable
• Able to perform in a fast paced and high-volume position
• Sharp attention to detail and thorough in completing tasks
• Strong data entry skills- keyboarding/accuracy/speed
• Working knowledge of Microsoft suite (i.e. Outlook, Word and Excel) and Adobe Acrobat
• Excellent communication skills, verbal and written
• Be a strong team player and displaying a good-natured, cooperative attitude
• Ability to manage multiple streams of work simultaneously using good planning, organization, multi-tasking, and prioritization in order to meet deadlines

Being part of our team is many things – exciting, rewarding, fun and challenging. Because we are part of a dynamic industry there is a can-do, dynamic spirit, which inspires our people to keep pushing forward the boundaries for what we can accomplish for our clients.