Credentialing & Provider Enrollment Specialist (Remote)

Credentialing & Provider Enrollment Specialist

(Remote)

Main Responsibilities (may include but are not limited to):

• Facilitate and complete submission of applications to enroll group and individual providers with Medicare, Medicaid, and commercial payers in multiple states (including WA, OR, UT, ID)
• Ensure enrollment applications are submitted accurately and timely to payers
• Initiate follow up on submitted applications
• Respond timely to requests for additional information when prompted by the payers
• Responsible for updating our group and provider information both internally within our organization and externally with the payers
• Conduct audit verifications in CAQH profiles to ensure validity of data
• Maintain and organize all documents necessary for the enrollment process
• Utilize tracking system to maintain and organize provider records and submitted enrollment applications 
• Identify trends to recurring issues or barriers with payers and communicate proactively to management 
• Other duties as assigned

Skills required to succeed: 

• 2 years of credentialing experience and working with insurance payers is required 
• 2 years direct knowledge and experience using sites CAQH, PECOS, and NPPES is required
• CredentialMyDoc experience preferred, but not required
• Strong work ethic with extremely high attention to detail and excellent use of critical thinking skills
• Excellent organization and use of time management skills
• Ability to prioritize workload and have a strong sense of urgency when time sensitive situations arise
• Strong verbal and written communication, as well as customer service skills; must be able to listen and communicate effectively with partner facilities, co-workers, patients, and insurance companies
• Knowledge of applicable federal, state and local laws and regulations including the requirements of the HIPAA and OSHA regulations pertinent to medical practices, and must be able to maintain confidentiality 
• Proficient with computers and navigating within multiple web browsers 
• Experience navigating common insurance payer provider portals 
• Proficient in MS Office (specifically Outlook, Excel, Word, and Teams) 
• Must be punctual, dependable, and able to work independently
• Must be trustworthy, honest and have a positive and professional attitude

Compensation: $22.00-$29.00 DOE and location.

This position is classified as: Hourly, Non-Exempt; Full-Time employment

Hours: Typical hours are Monday through Friday; 7:30am – 4:00pm PST, (occasional overtime depending on volume)

Benefits:

• Work remotely from a home office
• Associates working 20 hrs per week: 
  1. Medical/Dental/Orthodontic/Vison/RX – minimum 80% towards employee monthly premiums covered, dependent coverage available at employee’s expense
  2. Employer Sponsored Life, AD&D, and Disability Insurance 
  3. Voluntary Supplemental Insurance: Accident, Cancer, Critical Illness, STD, Life, Identity Protection, Financial Wellness, and Legal Plan coverages available
• Paid Time Off: 
  1. PTO accruals up to 132hrs your first year of employment based on FTE status
  2. 8 paid Holidays for full-time employees
• 401(k) match on first 4%
• Core Values that promote work-life harmony
• Work with amazing people who have created a culture where we recognize each other’s wins and don’t tolerate gossip or drama

                                                                                             
Website: www.unitedwoundhealing.com 

*Do you want to grow personally and professionally by working with the best?   We’d love to hear from you!  Apply now:

We are a drug-free workplace. All offers of employment are contingent upon a successful drug screen and criminal background check. EEO.