Match score not available

Credentialing Specialist (Remote)

Remote:

Full Remote

Experience:

Mid-level (2-5 years)

Work from:

New Jersey (USA), United States

Offer summary

Qualifications:

3 years' experience in provider enrollment, Knowledge of payer's enrollment processes, Detail oriented and organized, Proficient in Microsoft Office applications.

Key responsabilities:

Prepare provider enrollment applications
Communicate with providers about their status

Ennoble Care SME https://ennoblecare.com/

See more Ennoble Care offers

Job description

About Us

Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, and Georgia. Ennoble Care’s clinicians go to the home of the patient, providing continuum of care for those with chronic conditions and limited mobility. Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. We seek individuals who are driven to make a difference and embody our motto, “To Care is an Honor.” Join Ennoble Care today!

Job Description:

The Credentialing Specialist is responsible for the timely execution of all group applications and provider applications/link letters. Serving as the point of contact for the organization’s credentialing application process, the Credentialing Specialist will communicate with providers and all teams to ensure accurate and up-to-date information regarding provider’s enrollment status.

Responsibilities:

Prepare new and existing provider enrollment applications and/or written link letters
Create and submit new group enrollment applications when contracts are executed
Follow up timely with payers on submitted applications/letters for approval notices
Ensure timely revalidation of all providers and groups
Communicate with providers and other team members to resolve payer issues and confirm participating status
Manage all documentation in an organized manner – upload documentation to a shared drive and update Modio
Track all provider licensure and communicate with provider prior to expiration
Complete, update and maintain CAQH profiles for providers
Identify and communicate any potential enrollment issues that could result in loss of revenue
Establish relationships and maintain communication with provider representatives
Set up provider portals and maintain access for team members as needed
Participate in team meetings and communications
Perform specific assignments as directed by the Revenue Cycle Director

Qualifications:

Maintain regulatory requirements, including all federal, state, local regulations and accrediting organization standards
Knowledge of government and commercial payer’s enrollment processes and requirements
Minimum 3 years’ experience in provider enrollment
Preferred experience with Modio Health
Detail oriented, organized and able to multitask
Strong interpersonal and organizational skills
Excellent customer service skills
Able to work in a fast-paced, acquisitional environment
Represent the organization in a positive and professional manner
Demonstrated knowledge and experience working with the provider enrollment
Comply with all organizational policies regarding ethical business practices
Proficient in all Microsoft Office applications

Full-time employees qualify for the following benefits:

Medical, Dental, Vision and supplementary benefits such as Life Insurance, Short Term and Long Term Disability, Flexible Spending Accounts for Medical and Dependent Care, Accident, Critical Illness, and Hospital Indemnity.
Paid Time Off
Paid Office Holidays

All employees qualify for these benefits:

Paid Sick Time
401(k) with up to 3% company match
Referral Program
Payactiv: pay-on-demand. Cash out earned money when and where you need it!

Ennoble Care is an Equal Opportunity Employer, committed to hiring the best team possible, and does not discriminate against protected characteristics including but not limited to - race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.