Credentialing & Enrollment Coordinator, Provider Enrollment/Medical Staff Office (40 hrs, Days)

BMC Software; Boston (MA); On-site; USD 24,000 - 34,000; Full time

Job summary

Boston Medical Center seeks a Credentialing & Enrollment Coordinator in Provider Enrollment to manage timely credentialing for medical-dental staff and enrollment with third-party payors. You will gather provider data, update records, and coordinate with the Medical Staff Office to support the foundation's goals.

The role requires strong organization, attention to detail, confidentiality, and the ability to prioritize in a busy environment.

Qualifications

• Associates degree or equivalent experience; Bachelor’s degree preferred.
• High School Diploma required.
• 1–3 years experience in a healthcare system or related setting.
• Knowledge of credentialing and/or enrollment required.
• Proficiency with Microsoft Office applications and CAQH is a plus.

Responsibilities

• Coordinate credentialing and enrollment for providers and staff.
• Request and obtain provider data and maintain records.
• Maintain provider information in existing computer systems.
• Collaborate with the Medical Staff Office and external agencies.

Skills

Communication

Time management

Organizational skills

Problem solving

Confidentiality

Education

Associate's degree or equivalent experience

Bachelor’s degree preferred

High School Diploma required

Tools

Microsoft Office

CAQH system

Job description

POSITION SUMMARY** : **

Under the supervision of the Director, Medical Affairs and Manager of Provider Enrollment, is responsible for the timely credentialing for all Medical-Dental Staff and enrollment of all new and existing Faculty Practice Foundation practitioners with third party payors. Requests and obtains provider data. Maintains provider information in existing computer software systems.

Requires an individual with strong organizational skills, detail oriented with an ability to work in varied and busy atmosphere and an individual who can independently organize and prioritize the workload to support the goals of the Boston Medical Center and Faculty Practice Foundation. Maturity, discretion and an ability to maintain confidentiality are of utmost importance.

Position: Credentialing & Enrollment Coordinator, Provider Enrollment

Department: Medical Staff Office

Schedule: Full Time, 40 hrs, Days

JOB REQUIREMENTS

EDUCATION:

• Associates degree or equivalent experience. Bachelor’s degree preferred
• High School Diploma required.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED

• CPSC: Certified Provider Credentialing Specialist, preferred

EXPERIENCE:

• Requires 1 - 3 years experience in a healthcare system, group practice, Medical Staff Office, credentials verification organization or health plan. A bachelor’s degree in information systems or healthcare management or previous database administrator experience may be substituted for the required experience.
• Knowledge of provider credentialing and/or enrollment required.

KNOWLEDGE AND SKILLS:

• Work requires basic knowledge of credentialing and enrollment procedures / requirements.
• Ability to work well with all levels of personnel to establish and maintain harmonious working relationships with providers, chiefs of service, department directors and administrative staff and outside agencies.
• Strong communication, time management and organizational skills required to keep a very large and complex system running efficiently. Ability to prioritize duties and meet deadlines.
• Work requires ability to consolidate information from various sources. Ability to identify problems in the credentialing and enrollment process and strong problem solving skills needed to resolve any problem as they arise.
• Proficiency with Microsoft Office applications (i.e. MS Word, Excel, Access, PowerPoint, Outlook) and web browsers. Experience with CAQH system and third party insurance Website a plus.
• Skilled in basic computer programs, such as Word and Excel. Experience with Microsoft Office.
• Promotes and maintains a professional demeanor both personally and for BMC & the FPF.
• Able to function independently and perform routine department procedures without supervision.
• Must have proven ability to maintain sensitive and confidential information.

Compensation Range:

$21.39- $30.05

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.

NOTE

This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans