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Credentialing Specialist
4 weeks ago
We are seeking a skilled Credentialing/Payor Enrollment Specialist to join our team at PeopleShare Inc. The ideal candidate will have a strong background in credentialing and payor enrollment, with a proven track record of success in ensuring timely and accurate processing of provider enrollments.
Key Responsibilities:- Submit initial and re-credentialing enrollment applications for payor HMO, Medicare, and Medicaid enrollments.
- Track and follow up on submitted applications with payors, ensuring timely processing and tracking provider ID numbers and effective dates.
- Serve as a liaison between the billing department and payors to troubleshoot claims denials related to provider enrollment issues.
- Maintain a matrix of all facility and provider expiring credentials needed for provider enrollment.
- Ensure a high level of organization and attention to detail in all credentialing tasks.
- At least 1 year of credentialing experience; 2-4 years preferred.
- Familiarity with payor portal software (a plus).
- Proficiency in computer software (Excel, Word, Outlook).
- Strong organizational skills and ability to manage multiple projects under time-sensitive deadlines.
- Excellent written and verbal communication skills.
- Ability to work both independently and as part of a team.
- High school diploma or GED required.
- Opportunity for growth and career development.
- Positive, team-oriented environment with a focus on personal and professional success.
- Flexible scheduling options for the right candidate.
