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Provider Enrollment and Credentialing Coordinator

2 months ago


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

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

About Hydro Recruiting: Hydro Recruiting is dedicated to connecting top talent with innovative healthcare organizations. We are proud to support a leading physician-owned health and wellness clinic focused on enhancing community health outcomes.

Mission and Philosophy: The clinic is driven by a team of dedicated physicians committed to transforming healthcare delivery. Their goal is to improve patient outcomes through integrated care that includes specialized treatments and preventive services. The clinic values a holistic approach to health, utilizing advanced technology, promoting teamwork, and ensuring a manageable patient load to foster meaningful interactions with healthcare professionals.

Position: Credentialing and Enrollment Specialist In this role, you will be responsible for managing the enrollment and credentialing processes for healthcare providers, ensuring compliance with regulatory standards and accurate registration with insurance providers. You will maintain comprehensive records and oversee the entire credentialing cycle.

Duties/Responsibilities:
  • Manage the complete process of provider enrollment and credentialing.
  • Gather and process necessary documentation from providers.
  • Submit and track applications to insurance companies and regulatory bodies.
  • Maintain current records of provider credentials and compliance.
  • Ensure compliance with all relevant healthcare regulations and standards.
  • Collaborate with internal teams to enhance the credentialing process.
  • Stay informed about regulatory changes impacting credentialing requirements.
  • Prepare regular reports for management regarding credentialing statuses.
  • Assist with audit preparations and manage provider privileges.
  • Perform additional responsibilities as needed.
Education/Certifications/Licenses:
  • Bachelor's degree in Healthcare Administration, Business Administration, or a related field (Preferred).
  • Certifications such as Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) from NAMSS (Preferred).
  • Extensive experience in healthcare administration, credentialing, and privileging (Required).
Experience:
  • Demonstrated experience in credentialing and provider enrollment (Required).
  • Knowledge of major healthcare insurers and compliance with healthcare laws.
  • Experience with credentialing software is advantageous.
Required Skills/Abilities:
  • Exceptional organizational skills and keen attention to detail.
  • Strong communication and interpersonal abilities.
  • Proficient in Microsoft Office Suite and healthcare billing processes.
  • Ability to maintain confidentiality and adapt to evolving regulations.
  • Team-oriented with a strong focus on customer service.
Opportunities: This position offers a valuable opportunity to contribute to a high-quality healthcare service delivery system, ensuring patient satisfaction and adherence to healthcare regulations. The role provides significant potential for career advancement and professional development in a dynamic environment.