Register
Recruit Create CV

Credentialing And Enrollment Specialist Jobs

Hospital And Facility Credentialing Specialist
By River Region Psychiatry Associates LLC At United States
Investigate candidates’ prior education, experience, and training to see if they qualify for a certain certificate.
A minimum of 2 years of Hospital credentialing experience.
Knowledge of medical credentialing procedures.
Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS).
Excellent communication and organizational skills. Proficient in MS Word and Excel.
Examine resumes, transcripts, and letters of recommendation to ascertain a candidate’s suitability for a position.
Provider Enrollment And Credentialing Specialist
By Bikham Information Technologies At , Remote
Knowledge and experience with CRMs
5+ years of experience in client-facing roles required
Knowledge of US Healthcare would be a big plus
Healthcare sales experience is a big plus
Working for a successful company where employees are highly respected and not micromanaged.
Being available to speak on the phone with providers and team members when needed during work hours.
Authorization And Credentialing Specialist
By Philadelphia Mental Health Center At Philadelphia, PA, United States
Remote or hybrid work, FT with benefits, 40K+
Experience with multiple insurances, experience with CBH, Credible, Excel
Must be detail oriented, motivated, reliable, a team player.
-Identify and document each commercial payer's policy and procedures regarding coverage, priorauthorizations,andsubmissionprocess
-Follow up with commercial insurance payers to check status of previously submitted priorauthorization
-Quick to respond and communicate any changes in client's prior authorization status to careoperations,clinical,andpartnershipsteams.
Credentialing And Enrollment Specialist
By Altais At Oakland, CA, United States
Responsible for communicating provider changes to contracted health plans and Altais Medical Group management via standardized report(s)
Works with payors to facilitate issue resolution, re-enrollment, and termination requirements
Facilitate annual employee health requirements for providers
Excellent computer skills including Microsoft Office (Word, Outlook, Excel, PowerPoint)
Excellent communication skills, both written and verbal
3+ years of Health Plan/Medical Group experience with preferred experience with an IPA
Provider Enrollment & Credentialing Specialist, Dentaquest
By DentaQuest At United States
Verify potential and existing providers licensure, NPI, insurance, CDS, DEA certificate, education, hospital privileges, board certification.
Monitors and reports provider complaints and utilization management reports
Assist management in the implementation of department process improvements.
Assist with the ongoing NCQA certification activities.
Associate degree or equivalent experience required.
Excellent oral and written communication skills.
Enrollment And Billing Specialist
By Delta Dental of Idaho At Boise, ID, United States
Strong time management skills with the ability to determine priorities and critical tasks.
Serve as a liaison with subscribers, groups, and agencies to answer eligibility, benefit, payment, electronic enrollment file and contract questions.
Experience in bookkeeping, AP/AR, accounting, or a related field.
Detail-oriented with the ability to understand benefits and contract provisions.
Strong written and verbal communication skills.
Skill/ability related to comprehension, organization, reasoning/decision-making and communication appropriate to position/level
Inbound And Outbound Enrollment Specialist
By Anthology Inc At United States
Computer knowledge and internet navigation skills
High School diploma or equivalent combination of education and experience
Developing relationships with parents as an educational advisor and consultant generating and enhancing interest in the various client products and services
Must be able to work from home
Ability to identify customer educational needs and find appropriate solutions
Effective oral and written communication skills
Credentialing & Enrollment Liaison Jobs
By Privia Health At United States
Follows guidelines in alignment with all health plan requirements as related to the provider certification and credentialing.
Must be able to function independently, possess demonstrated flexibility in multiple project management
Works with care centers to obtain updates to licenses, certifications, and certificates of insurance and ensures timely renewal for the same.
2+ years healthcare experience working with providers and care center staff
Demonstrated skills in problem solving and analysis and resolution
High level of attention to detail with exceptional organizational skills
College And Regional Recruiting And Enrollment Specialist
By The Ohio State University At , Columbus, 43210, Oh $18.61 - $24.81 an hour
Primary administrator of the university visit/event management system in Salesforce (university customer relationship management tool (CRM)) called Blackthorn.
Manages prospective student visit programs for the college including daily visits and overview tours.
Recruits, trains, and oversees the development of student recruitment hosts who are an integral part of the visit experience.
Oversees daily responsibilities of two Student Visit Coordinators
Bachelor’s Degree or equivalent experience and a minimum of 2 years of relevant experience.
Assists with large recruitment event planning and supports other Prospective Student Services activities and events including National and State FFA Conventions.
Credentialing & Enrollment Specialist Jobs
By Privia Health At United States
Follows guidelines in alignment with all health plan requirements as related to the provider certification and credentialing.
Supports special projects requiring knowledge of delegated and non-delegated health plan requirements
2+ years experience in managed care credentialing, billing and/or Medical Staff service setting
Must be able to function independently, possess demonstrated flexibility in multiple project management
Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.
Demonstrated skills in problem solving and analysis and resolution
Credentialing Specialist Jobs
By symplr At , From $20 an hour
Process, review and maintain all practitioner/provider credentialing and re-credentialing files and offer solutions regarding the workflow of credentialing files.
Solid working knowledge of credentialing software applications and/or other relational databases like Access.
Excellent communication skills - both verbal and written.
Certification as a CPCS (Certified Provider Credentialing Specialist) by NAMSS preferred but not required.
Enter and update practitioner/provider data in the credentialing database while adhering to input standards.
Processes complete initial and re-credentialing applications within the expected timeframes.
Intake And Enrollment Specialist
By Center For Disability Services At , Albany, 12208, Ny $21.78 - $23.78 an hour
Complete screenings and assessments of individuals needs to make recommendations to program management
At least 3 years of job related experience, specifically in the field of Human Services
The Center for Disability Services offers hope, innovation and achievement to the people we support.
The compensation range for this position is $21.78 - $23.78. Rate of pay is commensurate on experience.
Responsible for responding to initial requests for information regarding services and provides linkage and referral to CFDS services accordingly
Maintains current information on Center programs and services and community resources
Credentialing Specialist Jobs
By South Texas Renal Care Group At San Antonio, TX, United States

SOUTH TEXAS RENAL CARE GROUP 215 N San Saba Ste 206, San Antonio TX 78207 Credentialing Specialist Summary Evaluates, analyzes, and coordinates all aspects of the credentialing and recredentialing ...

Medical Staffing And Credentialing Manager
By aptihealth At Saratoga Springs, NY, United States
Working knowledge of Credentialing Standards and Guidelines in Credentialing, Recredentialing, and other regulatory/compliance requirements.
Competitive pay, benefits, and stock options
Continuously provide excellent customer service skills by following up with external providers and partners accurately and professionally.
Associate's degree or equivalent experience
At least 3 years’ experience in medical Credentialing.
Competent in all aspects of Credentialing and adhering to all company policies, procedures, state, federal, and certification agencies.
Credentialing Specialist/Medical Enrollment Specialist $50K-$60K
By Ultimate Staffing At Bloomington, MN, United States
Maintain databases with all up to date education, training, experience, and licensure content
Type: Direct hire with benefits
Track provider credentials, memberships, certifications & licensures to ensure records are kept up to date and consistent with regulations and policies
3+ years of experience in credentialing and/or provider enrollment - required
Any experience using Qgenda would be amazing – can be taught if you’ve never used this software system
Knowledge of medical terminology - required
Provider Data And Enrollment Specialist Ii
By Sentara Healthcare At , Norfolk, 23502, Va $48,464 - $68,141 a year

For applicants within Washington State, the following hiring range will be applied: $48,464.00 to $68,140.80 annually.

Credentialing Specialist Jobs
By Johns Hopkins University At , Baltimore, 21218, Md

Location: Johns Hopkins Health System, Baltimore, MD 21201 Category: Clerical and Administrative Support Schedule: Day Shift Join an amazing global healthcare organization with lots of ...

Are you looking for an exciting opportunity to join a growing team of Credentialing and Enrollment Specialists? We are looking for a motivated and detail-oriented individual to join our team and help us ensure that our clients receive the best service possible. As a Credentialing and Enrollment Specialist, you will be responsible for verifying and processing insurance applications, verifying eligibility, and enrolling clients in their insurance plans. If you are looking for a challenging and rewarding career, this is the perfect job for you!

Overview:

Credentialing and Enrollment Specialists are responsible for verifying the credentials of healthcare providers and enrolling them in insurance plans. They review applications, verify credentials, and ensure that all documents are accurate and up-to-date. They also coordinate with insurance companies to ensure that providers are enrolled in the right plans. Credentialing and Enrollment Specialists must have excellent organizational and communication skills, as well as a thorough understanding of the healthcare industry.

How To Become an Credentialing And Enrollment Specialist:

To become a Credentialing and Enrollment Specialist, you must have a high school diploma or equivalent. You may also need to complete a certification program in medical coding or healthcare administration. Additionally, you should have experience working in the healthcare industry, such as in a hospital or doctor’s office.

Credentialing And Enrollment Specialist Skills:

• Knowledge of healthcare industry regulations and standards
• Excellent organizational and communication skills
• Attention to detail
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office Suite
• Knowledge of medical coding and insurance plans
• Ability to multitask and prioritize tasks

What is Credentialing And Enrollment Specialist Knowledge?

• Knowledge of healthcare industry regulations and standards
• Knowledge of medical coding and insurance plans
• Knowledge of HIPAA regulations
• Knowledge of credentialing and enrollment processes
• Knowledge of healthcare provider databases

What is Credentialing And Enrollment Specialist Responsibilities?

• Reviewing applications and verifying credentials of healthcare providers
• Ensuring all documents are accurate and up-to-date
• Coordinating with insurance companies to ensure providers are enrolled in the right plans
• Maintaining and updating provider databases
• Assisting with credentialing and enrollment processes
• Answering questions and providing customer service

What is Credentialing And Enrollment Specialist Experience?

• Previous experience working in the healthcare industry
• Experience with medical coding and insurance plans
• Experience with credentialing and enrollment processes
• Experience with healthcare provider databases

What is Credentialing And Enrollment Specialist Qualifications?

• High school diploma or equivalent
• Certification in medical coding or healthcare administration
• Knowledge of healthcare industry regulations and standards
• Knowledge of medical coding and insurance plans
• Knowledge of HIPAA regulations
• Knowledge of credentialing and enrollment processes
• Knowledge of healthcare provider databases

Credentialing And Enrollment Specialist Education:

• High school diploma or equivalent
• Certification in medical coding or healthcare administration
• Bachelor’s degree in healthcare administration or related field
What tools help Credentialing And Enrollment Specialist work better?
• Electronic health records (EHR) systems
• Credentialing and enrollment software
• Medical coding software
• Insurance plan databases
• HIPAA compliant databases
Good tips to help Credentialing And Enrollment Specialist do more effectively?
• Stay up-to-date on healthcare industry regulations and standards.
• Develop strong organizational and communication skills.
• Maintain accurate and up-to-date records.
• Utilize technology to streamline processes.
• Prioritize tasks and manage time effectively.
Common Credentialing And Enrollment Specialist interview questions?
• What experience do you have working in the healthcare industry?
• What knowledge do you have of medical coding and insurance plans?
• How familiar are you with HIPAA regulations?
• What experience do you have with credentialing and enrollment processes?
• How do you ensure accuracy when verifying credentials?