Payer Enrollment Specialist

3 weeks ago

Norwood, Ohio, United States Equiliem Full time
Payer Enrollment Specialist Job Description

A position responsible for the credentialing of physicians and allied health providers.

Key Responsibilities:
  • Complete and review Provider applications with accuracy and thoroughness, contact providers for application information when necessary, contact government agencies and managed care companies to obtain status and resolve discrepancies related to provider applications, and follow-up with physicians and assist with completing applications.
  • Ensure timely submissions of all re-appointments and re-credentials, verifies all licenses are current, and maintains internal files, including copies of current credentials.
  • Follow up and communicate regularly with TCHMA Administration, Billing Dept. and Office Managers.
  • Maintain accuracy of and update CAQH database.
  • All other duties as assigned.
Required Skills & Experience:
  • 3-5 years' experience in credentialing.
  • Must have 5 years of experience in Physician/ Advanced Practice Payer enrollment, in a hospital setting. Not with an insurance company
  • Excellent computer skills, to include word processing, spreadsheet and database management.
  • Ability to work under pressure and adaptable to change.
  • Attention to detail and accuracy are essential.
  • Must have worked previously in a hospital system (Will not accept any Nursing, allied or agency credentialing specialist experience.)
  • Strong CAQH knowledge
  • Strong Excel experience
  • Preferred: Cactus/Symplr
About Equiliem:

Equiliem believes in empowering success. It's our job to cultivate relationships that connect people and employers in a way that is inclusive, intelligent, and allows both to thrive.

Across the U.S., leading companies in healthcare, government, engineering, manufacturing, professional services, and energy rely on us for their workforce solutions. Our recruiting and HR services include contract and direct hire staffing, Payrolling/EOR, Independent Contractor Compliance, and Managed Services.

For almost 30 years, we've helped shape our industry. Today, we continue to research, ask questions, and continuously enhance the candidate journey and client experience.

Equiliem is an equal opportunity employer. We do not discriminate or allow discrimination based on race, color, religion, creed, sex, age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Equiliem will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

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