Medicare Credentialing Specialist

4 days ago

Hesperia, California, United States LHH Recruitment Solutions Full time

{"h1": "Medicare Credentialing Specialist Job Description", "p": "LHH Recruitment Solutions is seeking a skilled Medicare Credentialing Specialist to join our team. As a key member of our Credentialing and Enrollment team, you will be responsible for completing Medicare enrollments for individual providers and organizations across multiple states.

Responsibilities:

* Prepare and submit applications for State Medicaid programs.
* Follow up on provider applications for State Medicaid programs.
* Review initial applications, identifying potential issues for further investigation.
* Validate enrollment discrepancies and conduct necessary follow-ups.
* Collaborate with peers to assess the impact of issues on the enrollment process.
* Build and maintain relationships with providers and agency liaisons to gather required documents.
* Communicate and advise providers on the enrollment process from beginning to approval.
* Ensure adherence to State Medicaid policies during the enrollment process.
* Interact with State Medicaid representatives to clarify requirements.
* Respond to internal and external inquiries regarding enrollment status.
* Monitor demographic changes and submit provider updates to State Medicaid.
* Oversee provider enrollment revalidations.
* Enroll eligible providers for Medicare.
* Perform direct data entry into the database.
* Conduct Quality Control activities and prompt providers as necessary.
* Assist in analyzing Medicare enrollment issues, identify trends, and recommend solutions.

Requirements:

* Must have Medicare provider enrollment experience in NY, NC, or CA.
* A minimum of 2 years of experience with Federally Qualified Health Centers.
* A minimum of 2 years of recent credentialing experience specifically Medicaid and Medicare
* Remote, but candidate must reside in CA, NY or NC

Benefits:

* Competitive hourly rate: $22.00 to $25.00 per hour
* Medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and a 401K plan
* Paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: The California Fair Chance Act, Los Angeles City Fair Chance Ordinance, Los Angeles County Fair Chance Ordinance for Employers, and San Francisco Fair Chance Ordinance
"}

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