Credentialing & Payer Enrollment Leader

Cape Fear Valley Health; Fayetteville (NC); On-site; USD 85,000 - 120,000; Full time

Job summary

Cape Fear Valley Health System is seeking a Manager to oversee payer enrollment activities for employed and certain contracted providers, hospitals and group practices. This role partners with Physician Financial Services to ensure accurate enrollment, revalidations, and data integrity across NPI, PECOS and NC Medicaid systems.

The ideal candidate will drive enrollment quality, coordinate with CAQH and hospital departments, and mentor staff to maintain timely, compliant processes within the

Qualifications

• 2 years’ experience in credentialing and/or provider enrollment in a large multi-specialty health system
• Associate degree required or 4 years’ experience as a practice manager or administrator will be considered in lieu of degree
• Bachelor’s degree preferred

Responsibilities

• Coordinate enrollment activities with physician groups and hospital departments to ensure proper payment
• Work with Medical Group and Medical Staff Services to onboard providers and new groups from a payer enrollment perspective
• Collaborate with CAQH and other organizations on credentialing applications processing
• Ensure NPI registry, PECOS, NPPES and NC Medicaid data consistency for CFV entities
• Manage enrollments, reenrollments and revalidations in a timely, accurate manner
• Provide quality control to ensure staff are trained and perform duties accurately
• Perform other duties as assigned

Skills

Interpersonal skills

Written and verbal communication

Team player

English proficiency

Education

Associate degree

Bachelor's degree preferred

Tools

Microsoft Word

Excel

PowerPoint

Access

Job description

Cape Fear Valley Health System is seeking a Manager to oversee payer enrollment activities for employed and certain contracted providers, hospitals and group practices. This role partners with Physician Financial Services to ensure accurate enrollment, revalidations, and data integrity across NPI, PECOS and NC Medicaid systems.

The ideal candidate will drive enrollment quality, coordinate with CAQH and hospital departments, and mentor staff to maintain timely, compliant processes within the