Credentialing & Enrollment Specialist, Managed Care

Cardinal Health; Annapolis (MD); On-site; USD 25,000 - 41,000; Full time

Benefits offered by this job

Health insurance

Paid time off

401k Savings plan

MyFlexPay

FSAs

Disability coverage

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Job summary

Cardinal Health is seeking a Coordinator, Managed Care, Credentialing to ensure active credentialing/enrollment status with all contracted payors for all groups and providers. You will maintain licensure and certifications and support enrollment activities across regions.

Responsibilities include documenting credentialing activity, monitoring licenses, coordinating provider enrollment, meeting deadlines, and collaborating with the Credentialing Supervisor to update progress.

Qualifications

• At least three (3) years of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database.
• Specific knowledge of the payer environment and payer issues
• Ability to work a flexible schedule (including overtime, and weekends), as necessary.
• Excellent customer service and communication skills.
• Ability to work independently and as part of a team.
• Working experience with Excel spreadsheets and Microsoft Word documents.
• College degree or commensurate working experience in healthcare.
• Knowledge of basic medical terminology.
• Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.)

Responsibilities

• Document and track all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform
• Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
• Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
• Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
• Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
• Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
• Ensure that all processing and reporting deadlines are consistently achieved.
• Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
• Performs any other functions as required by management.

Skills

Credentialing experience

Payer enrollment

Customer service

Communication skills

Teamwork

Flexible schedule

Medical terminology

Education

College degree or commensurate experience in healthcare

Medical terminology knowledge

Tools

IntelliCred

E-Vips

Vistar

Cactus

Symed

Excel

Word

Job description

Cardinal Health is seeking a Coordinator, Managed Care, Credentialing to ensure active credentialing/enrollment status with all contracted payors for all groups and providers. You will maintain licensure and certifications and support enrollment activities across regions.

Responsibilities include documenting credentialing activity, monitoring licenses, coordinating provider enrollment, meeting deadlines, and collaborating with the Credentialing Supervisor to update progress.