Provider Credentialing Coordinator
2 weeks ago
The Healthcare Provider Enrollment Specialist plays a crucial role in facilitating the enrollment of healthcare practitioners with various health insurance plans, ensuring timely processing and minimizing the risk of claim denials.
This position involves the collection and management of provider credentials and necessary documentation for the enrollment of individual practitioners with payers. The specialist will oversee the completion of the Council for Affordable Quality Healthcare, Inc. (CAQH) credentialing process for new providers and maintain updated records for existing ones.
Key Responsibilities:
- Execute applications, re-credentialing requests, and demographic updates to all relevant payers.
- Conduct thorough research on payer processes to facilitate provider enrollment.
- Monitor and follow up on the status of applications, ensuring timely updates on pending and completed submissions.
- Engage with payers to obtain effective dates, status updates, and identification numbers necessary for provider payments and claims processing.
- Support the physician onboarding process by assisting with credentialing and enrollment applications.
- Investigate and resolve any provider-related enrollment issues, collaborating with colleagues as needed.
- Maintain organized provider files for the revalidation of Medicaid and Medicare enrollments.
- Ensure timely provider enrollments and complete other assigned duties as necessary.
Qualifications:
- An Associate's degree is required; a Bachelor's degree is preferred along with prior experience in a hospital business office setting.
- Excellent verbal and written communication skills are essential.
- Exceptional organizational abilities and strong attention to detail are necessary for success in this role.
- The ability to make independent decisions and manage multiple tasks effectively is crucial.
- Previous experience with data management and file organization is preferred.
- Candidates should be able to meet established production and quality standards and work collaboratively within a team environment.
- A quick learner with the ability to adapt to new software programs is highly valued.
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Provider Enrollment Coordinator
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Provider Enrollment Coordinator
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Montgomery, Alabama, United States Baptist Health Full timeBaptist Health stands as the premier healthcare provider in central Alabama, delivering extensive hospital and outpatient services to a significant portion of the local population. For further insights about Baptist Health, please visit our website.The Provider Enrollment Coordinator plays a crucial role in facilitating and managing the complete enrollment...
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Montgomery, Alabama, United States Baptist Health Full timeBaptist Health stands as the foremost healthcare system in central Alabama, delivering extensive hospital-based and outpatient services to a significant portion of the local population. To explore more about Baptist Health, please visit our website.The Provider Enrollment Coordinator plays a crucial role in supporting, organizing, and executing the entire...
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