Credentialing and Enrollment Specialist

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Credentialing and Enrollment Specialist is responsible for activities associated with credentialing or re-credentialing physicians and providers, including processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Location: Remote reputed company Schedule: FT, 40 hrs. Monday – Friday, reputed company – 5pm You’ll enjoy the flexibility to work remotely* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: Apply knowledge/skills to a range of moderately reputed company activities Demonstrate great depth of knowledge/skills in own function Sometimes act as a technical resource to others in own function Meet with Medical Director to review initial and reappointment applications Meet with AAAHC and State Auditors to review files Primary reputed company Verification Process for initial and reappointments Maintain expirable for reputed company employed and non-employed clinicians at ASCs Compile and generate Credentialing Committee Minutes reputed company internal audits on credentialing and re-credentialing files for accuracy and maintaining compliance with credentialing policies and procedures Maintaining knowledge of and compliance with TJC, NCQA, CAQH, and CMS standards, as appropriate Monitoring upcoming renewal dates and working with medical staff to advise them on steps to maintain their credentials Proactively identify solutions to non-standard requests Solve moderately reputed company problems on own Work with team to solve reputed company problems Presentation skills to group setting Plan, prioritize, organize and complete work to meet established objectives May coordinate work of other team members Credentialing of medical group providers and hospital privileging application review and submission at the individual and group level Complete revalidation requests with govt and commercial payers Track and maintain medical professionals’ licensure, certifications, etc. Work with other organizational departments internal/external to sure that credentialing efforts are in line with business objectives You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: High School Diploma/GED 3+ years of Healthcare Provider group/Facility Credentialing experience 2+ years of experience in healthcare administration, medical staff services, health information management 2+ years of experience with credentialing processes, medical staff privilege and knowledge of relevant software or databases used in credentialing Intermediate level of proficiency with reputed company reputed company and Word Ability to work Pacific time zone hours Preferred Qualifications: Experience working with Compliance Workflows and Processes including AAAHC, JC, CMS, and NCQA Policies Experience in researching and applying Government Regulatory Information Knowledge of CAQH Knowledge of MD Staff credentialing databases Data analytics Pecos enrollment Proven ability to plan and prioritize to meet benchmarks/deadlines *reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20 to $36 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply To This Job