Health Care Payer Credentialing/Enrollment Specialist
- $22 to $25 Hourly
Payer Credentialing/Enrollment Specialist
JOB TITLE: Payer Credentialing/Enrollment Specialist
Responsible for day-to-day Credentialing Services tasks to include payer enrollment, revalidations, and other miscellaneous tasks as required by payers; serves as point of contact for providers, groups and facilities, with insurances and other related entities.
· Work with contracted providers, group and/or facilities to meet credentialing service expectations
· Complete the processes to enroll and credential providers (physicians, groups, facilities, physician assistants, nurse practitioners, CRNAs, etc.) with insurance payers while meeting payer criteria
· Complete the processes to recredential existing providers, groups and/or facilities
· Gather and maintain current data and documents for all providers in accordance with policy and procedures
· Follow up with clients and payers for timely credentialing processes
· Clearly and effectively communicate with providers, operations managers, and insurance companies, handling basic questions dealing with the day-to-day operation of credentialing and enrollments
· Review and update, if necessary, health plan directories, agencies, and other appropriate entities for current and accurate provider information
· Knowledge of navigating and data entry of applications and spreadsheets
· Knowledge of provider and payer credentialing, accreditation, insurance regulations, policies, guidelines and standards
· Other duties as assigned
· High school degree or equivalent required
· Associate degree in business healthcare related field preferred or equivalent work experience
· Minimum of 2 years’ experience in payer enrollments, credentialing, and privileging, with heavy emphasis on payer enrollment experience (PESC, CPCS, and/or CPMSM preferred)
TRAITS AND APTITUDES:
· High level of awareness of pertinent details; excellent organization skills
· Strong analytic and problem-solving abilities
· Excellent verbal and written communication skills
· Ability to handle daily pressure and stress related to tight deadlines
· Must maintain confidentiality always
· Professional demeanor
· Excellent computer proficiency and skills with PC software (Microsoft Office Excel, Word, Power Point, OneDrive, Smartsheet), with the ability to quickly master programs necessary for the position
· Must be able to work independently and remotely
· Strong ability to manage time regarding tasks, turnaround time, and work/home time balance as a remote employee
· Honesty and strong moral compass
Salary range is $22/hour to $25/hour depending on experience.
· Flexible schedule
· Remote work
· Vacation pay
· Holiday pay
· 40 hours per week
Remote work (work from home)
OnPoint Solutions GroupLoveland, CO
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