Credentialing Analyst: Provider Onboarding & Enrollments

Snhhs; Nashua, Northern (NH, KY); Hybrid; USD 52,000 - 65,000; Full time

Benefits offered by this job

Health, dental, vision coverage

Disability & life insurance

Tuition reimbursement

403(b) retirement plan

Paid time off accrual

Job summary

Southern New Hampshire Health is seeking a Credentialing Analyst to manage credentialing for Foundation Medical Partners and onboarding for new providers. You will ensure payer enrollment and timely start dates to support our clinical teams across primary care, cardiovascular, cancer care, and more.

The role requires at least two years in healthcare credentialing, HS diploma, and familiarity with CAQH and credentialing software.

Qualifications

• Two years of healthcare office experience in credentialing.
• Certified Provider Credentialing Specialist (CPCS) designation is a strong plus.
• Proficient with Microsoft Office Suite and able to maintain complex databases.

Responsibilities

• Initiates the Medical/Allied Health Professional Staff appointment application process.
• Outlines licensing and DEA requirements for NH and MA.
• Verifies education contact information.
• Initiates/Updates Professional Liability Insurance.
• Prepares insurance applications for provider to complete and sign.
• Completes/updates cred entialing data in CAQH.
• Initiates/maintains enrollment with insurance plans.
• Follows up with insurance plan of provider effective date.
• Updates insurance plans with provider/practice change of information.
• Assists Business Office with resolving claim processing issues due to provider enrollment.
• Data entry in credentialing software for all provider license/DEA/Board expirations.
• Runs reports to notify provider and manager of expiring credentials.
• Follows up on expiring credentials to ensure compliance with employment agreements.
• Researches Federal, State and Local guidelines for licensing and credentials.
• Has exceptional attention to detail.
• Has excellent verbal and written communication skills.
• Prioritizes tasks to meet deadlines.

Skills

Communication skills

Attention to detail

Time management

Discretion

Education

High school diploma

CPCS certification

Tools

MS Office (Word, Excel, Outlook)

CAQH

Credentialing software

Job description

Southern New Hampshire Health is seeking a Credentialing Analyst to manage credentialing for Foundation Medical Partners and onboarding for new providers. You will ensure payer enrollment and timely start dates to support our clinical teams across primary care, cardiovascular, cancer care, and more.

The role requires at least two years in healthcare credentialing, HS diploma, and familiarity with CAQH and credentialing software.