Credentialing and Enrollment Specialist

3 months ago

Gillette, United States Hydro Recruiting Full time
Job Title: Credentialing and Enrollment Specialist

$10,000 Sign-on Bonus and $20,000 Relocation Assistance Available

About Our Client: Our client operates a cutting-edge, physician-owned health and wellness clinic situated in the picturesque town of Gillette, Wyoming. Established to address the community's growing health needs, the clinic offers a wide range of healthcare services aimed at improving patient well-being.

Mission and Philosophy: The clinic is led by a team of physicians dedicated to resolving long-standing issues in healthcare delivery. They aim to enhance patient lives by offering integrated care encompassing specialized treatments and preventive services. The clinic emphasizes a holistic approach to health, integrating advanced technology, fostering team collaboration, and maintaining a manageable patient load to enhance interaction with healthcare professionals.

Position: Healthcare Administrator As a Healthcare Administrator focusing on Provider Enrollment and Credentialing, you will ensure that healthcare providers are accurately registered with insurance providers and comply with regulatory standards. You will handle the comprehensive management of the enrollment and credentialing processes and maintain detailed records.

Duties/Responsibilities:
  • Oversee the full cycle of provider enrollment and credentialing.
  • Collect and process necessary documentation from providers for enrollment.
  • Submit and monitor applications to insurance bodies and regulatory agencies.
  • Maintain updated records of provider credentials and compliance.
  • Ensure adherence to all relevant healthcare regulations and standards.
  • Coordinate with internal teams to streamline the credentialing process.
  • Keep abreast of regulatory changes affecting credentialing requirements.
  • Generate regular reports for management on credentialing statuses.
  • Support audit preparations and manage provider privileges.
  • Handle additional responsibilities as required.
Education/Certifications/Licenses:
  • Bachelor's degree in Healthcare Administration, Business Administration, or related field (Preferred).
  • Certifications such as Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) from NAMSS (Preferred).
  • Significant experience in healthcare administration, credentialing, and privileging (Required).
Experience:
  • Proven background in credentialing and provider enrollment (Required).
  • Familiarity with major healthcare insurers and compliance with healthcare laws.
  • Experience with credentialing software is a plus.
Required Skills/Abilities:
  • Excellent organizational and meticulous attention to detail.
  • Strong communication and interpersonal skills.
  • Proficient with Microsoft Office Suite and healthcare billing processes.
  • Ability to maintain confidentiality and adapt to changing regulations.
  • Team-oriented with a strong customer service focus.

Opportunities: Joining our client offers a unique opportunity to contribute to a high-quality healthcare service delivery system, ensuring patient satisfaction and compliance with healthcare regulations. This role allows for significant career growth and learning in a dynamic environment.

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