Credentialing Specialist (Remote)

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

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 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