Provider Enrollment Specialist

 

We are seeking a credentialing candidate that is a highly motivated, autonomous individual who has a positive attitude to join our company as a Credentialing Specialist on the Managed Care Operations team.

 

 

Qualified candidates must possess:

• Minimum of 3-5 years’ experience credentialing providers
• Health plan knowledge and familiarity required credentialing all payor types:  Managed Care, Medicare & Medicaid Replacements & Workers Compensation
• Experience utilizing & maintaining credentialing database
• Highly knowledgeable & proficient with CAQH database. Familiarity with CAQH Practice Administrator role.
• Have established relationships with credentialing reps at various health plans
• Prepare and process credentialing applications for all payor types
• Experience credentialing multi-Tax ID entities
• Comfortable processing high volume credentialing applications & recredentialing applications
• Meet and adhere to company’s turnaround time and comply with credentialing goals and performance metrics
• Customer service oriented & easily able to develop relationships.
• Will have a detail-oriented and motivated work ethic, as well as capable of managing projects in a timely manner to meet set deadlines
• Possess excellent organizational, interpersonal, and communication skills 

MS Word, Excel & Access skills required