Credentialing & Enrollment Liaison Jobs

Company Description
Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Come join our amazing team at Privia supporting the national credentialing and enrollment team! The Credentialing & Enrollment Liaison is responsible for credentialing expirable tracking in CredentialStream and working with Care Centers to obtain updates, CAQH re-attestation oversight of third-party vendor while addressing questions/complex issues as they arise, enrollment audits for all new groups, and assist with EFT, EDI, ERA work in our claims system for all new markets.
Primary Job Duties

• Maintains confidentiality of provider information
• Works with AVP on all new markets and maintaining the athena table space.
• Works with care centers to obtain updates to licenses, certifications, and certificates of insurance and ensures timely renewal for the same.
• Reviews payer enrollment for all new groups and advises the Manager if there are any gaps or missing payers at least 90 days prior to Go Live.
• Interacts with varied levels of management, physician office staff and physicians effectively to accomplish credentialing and various elements of implementation and launch
• Updates CAQH attestation every 120 days.
• Other duties as assigned.
• Participates in onboarding of all new groups, particularly for enrollment process and overseeing/ensuring that providers are enrolled by reviewing CredentialStream.
• Follows guidelines in alignment with all health plan requirements as related to the provider certification and credentialing.
• Works with leaders to develop a new cadence for CAQH re-attestations so that there is a regular cycle for this process.

Qualifications
Minimum Qualifications:

• Must be able to function independently, possess demonstrated flexibility in multiple project management
• 2+ years healthcare experience working with providers and care center staff
• Demonstrated skills in problem solving and analysis and resolution
• Advanced Microsoft Excel skills
• Must comply with HIPAA rules and regulations

Interpersonal Skills & Attributes

• High level of attention to detail with exceptional organizational skills
• Exercise independent judgment in interpreting guidelines of applicable regulatory bodies.
• An individual with the ability to communicate appropriately and effectively with practitioners, internal stakeholders, and providers; including sensitive and confidential information

Colorado, New York, New Jersey, California and Washington Residents Only: The salary range for this role is $45,000.00-$55,000.00 in base pay and exclusive of any bonuses or benefits. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.