Credentialing & Enrollment Lead

Cape Fear Valley Health System; United States; Sur place; USD 88 000 - 112 000; Plein temps

Résumé du poste

Cape Fear Valley Health System is seeking a skilled leader to oversee payer enrollment activities across employed and certain contracted providers, hospitals, and group practices. This role will coordinate credentialing, onboarding, and data integrity across CAQH, PECOS, and NC Medicaid systems.

The ideal candidate brings experience with large multi-specialty health systems, strong communication, and a collaborative leadership style to ensure accurate and timely enrollments and revalidations.

Qualifications

• Associate degree or 4 years' experience in practice management considered in lieu of degree.
• Bachelor’s degree preferred for advancement and scope.
• 2 years’ experience in a large multi-specialty health system with credentialing or provider enrollment.
• Strong English communication and interpersonal skills.
• Proficiency with payer enrollment processes and CAQH/PECOS.

Responsabilités

• Collaborate with physician groups and departments on enrollment activities to ensure proper payment.
• Coordinate onboarding of providers for payer enrollment.
• Work with CAQH and other orgs on credentialing applications.
• Maintain consistent NPI, PECOS, NPPES and NC Medicaid data.
• Ensure timely enrollments, reenrollments and revalidations.
• Provide quality control and training for staff.
• Other duties as assigned.

Connaissances

Payer enrollment

Credentialing coordination

Provider enrollment

Regulatory knowledge

Leadership

Formation

Associate’s degree

Bachelor’s degree preferred

Outils

Microsoft Word

Excel

PowerPoint

Access

Description du poste

Cape Fear Valley Health System is seeking a skilled leader to oversee payer enrollment activities across employed and certain contracted providers, hospitals, and group practices. This role will coordinate credentialing, onboarding, and data integrity across CAQH, PECOS, and NC Medicaid systems.

The ideal candidate brings experience with large multi-specialty health systems, strong communication, and a collaborative leadership style to ensure accurate and timely enrollments and revalidations.