Managed Care Credentialing Specialist

4 weeks ago


Towson, Maryland, United States Sheppard Pratt Full time

Credentialing and Enrollment Administrator

At Sheppard Pratt, we are seeking a skilled Credentialing and Enrollment Administrator to support our team in managing the credentialing and enrollment process for our healthcare providers. The successful candidate will be responsible for processing credentialing and recredentialing materials, tracking the credentialing status of providers, and interfacing with managed care companies.

Key Responsibilities:

  • Process credentialing and recredentialing materials and enrollment applications
  • Track the credentialing status of providers and interface with managed care companies
  • Monitor delays in responses from companies and research problems that impact enrollment
  • Interface with Program Directors, Affiliate Directors, and Administrators regarding the enrollment process and status of providers
  • Establish and maintain a database of credentialing status and enrollment provider/rendering numbers
  • Develop guidelines, instructions, and articles to assist providers
  • Collect data, prepare reports, and provide administrative support for program development

Requirements:

  • Written and oral communication skills
  • Comprehensive knowledge of behavioral health billing requirements
  • Strong computer skills in Excel and Word
  • Interpersonal skills sufficient to communicate effectively with P.A. clinicians, Division Directors, contracted clinicians, and other internal staff
  • Proven project/program and problem-solving administrative skills

Benefits:

  • A commitment to professional development, including a comprehensive tuition reimbursement program
  • Comprehensive medical, dental, and vision benefits
  • 403b retirement match
  • Generous paid-time-off
  • Complimentary Employee Assistance Program
  • Generous mileage reimbursement program

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