CREDENTIALING & ENROLLMENT SPECIALIST

StrideCare; Addison (IL); Hybrid; USD 65,000 - 75,000; Full time

Job summary

StrideCare is seeking a Credentialing & Enrollment Specialist to manage end-to-end processes verifying provider qualifications and securing network participation with insurance payers. You will facilitate onboarding and revalidation activities and coordinate with providers, medical office staff, licensing agencies, and insurers.

Responsibilities include coordinating credentialing activities, maintaining databases for facilities and practitioners, tracking onboarding status, and supporting payor

Qualifications

• High School Diploma or equivalent.
• Associates or Bachelor's degree preferred.
• 3+ years in the healthcare industry.

Responsibilities

• Coordinate credentialing activities for onboarding initiatives.
• Collaborate with internal teams to ensure smooth provider onboarding.
• Maintain and update credentialing databases for facilities and practitioners.
• Communicate with providers, staff, licensing agencies, and payors.
• Assist with payor contracts as required.
• Participate in special projects and other duties as assigned.

Skills

HIPAA compliance

Microsoft Office

Organization skills

Multi-tasking

Background check

Education

High School Diploma or equivalent

Associates or Bachelor's degree preferred

Job description

All Jobs > CREDENTIALING & ENROLLMENT SPECIALIST

Job Summary:

The Credentialing & Enrollment Specialist is responsible for managing end-to-end processes of verifying healthcare provider qualifications and securing network participation with insurance payers. This team member will facilitate internal and external communications related to onboarding and revalidation activities, gather and organize pertinent information, and ensure all steps in the processes are completed efficiently and accurately.

Supervisory Responsibilities:

N/A

• Coordinate credentialing activities for routine and ongoing onboarding initiatives
• Collaborate with internal teams to ensure smooth transition for new practices and providers
• Obtain and organize information and documentation pertinent to the acquisition of practices and providers
• Track status of onboarding activities and provide updates to internal departments
• Coordinate malpractice insurance certificates
• Document processes and procedures for credentialing activities
• Maintain and update databases for facilities and practitioners
• Maintaining credentialing information database and ensuring up-to-date information is available for internal departments
• Communicate with providers, medical office staff, licensing agencies, and insurance carriers
• Provide support with payor contracts as required
• Participating in special projects and completing other duties as assigned
• Other duties as assigned.

Required Skills / Abilities:

• Compliance with all HIPAA policies
• Microsoft Office experience (Excel, Word, Outlook, PowerPoint)
• Excellent organization and communication skills
• Handle multiple projects simultaneously in a fast-paced environment
• Satisfactory criminal background check

Education and Experience:

• High School Diploma or equivalent, associate or bachelor's degree preferred.
• 3+ years in the healthcare industry

*StrideCare is an Equal Opportunity Employer and is committed to diversity and inclusion in our workforce. We encourage applications from candidates of all backgrounds and experiences.

Requirements

• Ability to sit for extended periods while working at a computer.
• Manual dexterity required for operating office equipment (e.g., computers, phones, fax machines).
• Ability to lift and carry up to 20 pounds occasionally.
• Visual acuity is required to perform tasks involving computer screens and paper documents.
• Ability to move around the office to access files, office machinery, and other equipment.

Salary Description

65,000 - 75,0000

Notice of AI Use in Job Application Review

As part of our commitment in creating a fair, efficient, and consistent hiring process we may use artificial intelligence (AI) to help our recruiting teams organize, summarize, and analyze information provided by candidates, including resumes, application responses, and other materials submitted during the application process.AI may be used to identify patterns, highlight relevant skills, and experience, and assist in comparing a candidate’s qualifications with the requirement of a specific role. These tools are to improve efficiency and consistency while supporting more informed hiring decisions, which will ultimately be made by the hiring team.