Provider Enrollment Specialist
$60,000–$60,000 year
Remote · Houston, Texas, United States
Job Summary
Credentialing Specialist on the Managed Care Operations team responsible for preparing and processing credentialing applications for all payor types, maintaining CAQH familiarity, leveraging CAQH database, building relationships with credentialing reps, handling high-volume credentialing and recredentialing, meeting turnaround times and performance metrics, and delivering customer-service oriented support with strong organizational, interpersonal, and communication skills; requires 3-5 years of credentialing experience and MS Word/Excel/Access proficiency.
Required Qualifications
- Minimum of 3-5 years’ experience credentialing providers
- Health plan knowledge and familiarity required credentialing all payor types (Managed Care, Medicare & Medicaid Replacements & Workers Compensation)
- Experience utilizing & maintaining credentialing database
- Highly knowledgeable & proficient with CAQH database (Familiarity with CAQH Practice Administrator role)
- Have established relationships with credentialing reps at various health plans
- Prepare and process credentialing applications for all payor types
- Experience credentialing multi-Tax ID entities
- Comfortable processing high volume credentialing applications & recredentialing applications
- Meet and adhere to company’s turnaround time and comply with credentialing goals and performance metrics
- Customer service oriented & easily able to develop relationships
- Possess excellent organizational, interpersonal, and communication skills
- MS Word, Excel & Access skills required
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