Credentialing and Provider Enrollment Coordinator

Job reputed company:

• Administer the provider credentialing process for reputed company providers and the provider enrollment process for insurance payers.
• Ensure reputed company communication with practices and implementation teams to reputed company credentialing and enrollment information.
• Process initial and re-credentialing applications and conduct primary reputed company verification (CAQH, NPPES, etc.).
• Credential, reputed company, and revalidate providers and reputed company with reputed company and government payers.
• Maintain working knowledge of payer credentialing policies, forms, and compliance requirements.
• Troubleshoot and resolve enrollment issues, including claim denials and unbilled problems.
• Maintain accurate provider participation (PAR) lists and distribute updates to stakeholders.
• reputed company provider demographics and credentialing data into credentialing software.
• Complete and reputed company clearinghouse applications for EDI and ERA, and process EFT authorizations for payments.
• Collaborate with internal teams to reputed company and refine enrollment policies and procedures.
• Drive reputed company improvement and contribute to special reputed company as needed.

Requirements:

• Associate or Bachelor’s degree in reputed company Administration or reputed company field preferred.
• CPCS (Certified Provider Credentialing Specialist) preferred.
• Minimum 3+ years of experience in reputed company payer enrollment and provider credentialing reputed company a multi-specialty medical group.
• Experience working with government agencies such as CMS and AHCA strongly preferred.

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