What are the responsibilities and job description for the Provider Enrollment / Credentialing Specialist position at COMPASSIONATE FAMILY MEDICINE?
Job Overview
As a Provider Enrollment / Credentialing Specialist, you will play a vital role in ensuring that healthcare providers meet the necessary qualifications and standards to deliver exceptional care. You will be responsible for verifying credentials, maintaining compliance with regulatory requirements, and supporting the overall credentialing process. Your attention to detail and knowledge of managed care and medical terminology will be essential as you navigate the complexities of provider credentialing.
What you’ll do
- Initiate enrollment with insurance companies for all new providers.
- Maintain the timelines on enrollment schedules, communicate with billing and office managers on updates as needed and explain payer information requirements.
- Work closely with physicians and office managers to obtain missing documentation on the providers for enrollment with insurance companies.
- Follow-up with insurance companies for providers participation status.
- Complete re-credentialing for existing providers.
- Able to effectively communicate with team members, billing staff and insurance companies.
- Retain detailed and accurate lists of insurances for which clients participate.
- Perform other related duties, which may be inclusive, but not listed in the job description.
Qualifications
- High School Diploma or GED required.
- Bachelor's degree preferred (not required with experience).
- Minimum of 2 years' experience in provider enrollment preferred.
- Knowledge of Medicare, Medicaid & third-party provider enrollment processes.
- Proficiency in Microsoft Office and EMR systems, MEDENT preferred.
- Proficiency in CAQH, PECOS & NPPES preferred.
- Strong understanding of managed care processes.
- Experience working in a medical office or healthcare setting.
- Familiarity with medical terminology and its application in credentialing.
- Previous experience with NCQA standards or similar accreditation processes.
- Professional written and verbal communication and interpersonal skills.
- Excellent organizational skills with a keen eye for detail.
- Ability to communicate effectively with diverse stakeholders.
About us
Compassionate Family Medicine is a busy private family medicine practice dedicated to providing high-quality, compassionate care to our patients. Join our dynamic team where your contributions will make a meaningful impact on the quality of healthcare services. We are committed to upholding high standards in provider credentialing while nurturing a culture that values collaboration, innovation, and excellence. Together, we can enhance the healthcare experience for providers and patients alike!
Job Type: Part-time
Pay: $18.00 - $25.00 per hour
Experience:
- Provider Enrollment: 2 years (Preferred)
Location:
- Syracuse, NY 13208 (Preferred)
Work Location: In person
Salary : $18 - $25