Job Details

Our Client, a Healthcare company, is looking for a Credentialing Enrollment Specialist for their Remote location.

Responsibilities:

• Performs primary source verifications of documentation required for managed care credentialing and re credentialing of MGD providers.
• Provide issue resolution and support regarding billing issues as they relate to provider enrollment and credential lien for MGD providers and the central billing office enters provider data in the echo database according to established departmental processes and provides feedback to other system entities as to the status of the applicants.
• Performs follow up on needed information ( expired licenses board certifications insurance, and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner.
• Prepares physician files or file audits by managed care organizations corporate compliance and accreditation entities conducts practice site visits for practices within MGD.
• Facilitates communication tools and or activities to maintain timely and accurate flow of information to managed care organizations (MCO) and the system
• Review hard copy and electronic provider directories and other information produced by managed care organizations reflecting CHS MGD and the systems demographics and participation
• Provides team member support to the CPN credentialing and quality review committee

Requirements:

• Experience with Computer, Xerox Machin, Fax machine, Printer, Telephone, Typewriter, and all related office equipment and supplies.
• High school diploma or GED required bachelor's degree preferred three years' experience in a role that performs or supports provider credentialing privileging and or enrollment in either a hospital, managed care plan RCMS environment is required.
• Knowledge of an experience with personal computers windows and Microsoft applications copiers and fax machines and multi-line telephone required.
• Certification through National Association of medical staff services (NAMMS) uh this is certified provider credential specialist (CPC) or professional medical services management (CPMSM) Preferred.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.