Credentialing & Payer Enrollment Specialist

Saint Joseph Medical Group; London (KY); On-site; USD 45,000 - 65,000; Full time

Job summary

CHI Saint Joseph Medical Group in Kentucky is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers in line with delegated agreements and regulatory requirements.

You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the medical staff office to ensure timely completion and compliance of the credentialing processes.

Qualifications

• Degree in Business or health related field and experience with Microsoft Word, Excel, and Website applications.
• Preferred credentials: Certified Provider Credentialing Specialist and Prof Medical Services Manager.

Responsibilities

• Facilitates credentialing and re-credentialing for all physicians.
• Assist with processing pre-applications, provisional reviews, and periodic review of privilege criteria.
• Systematically evaluate work processes.
• Participate in conception, development and implementation of new programs.
• Maintains the medical staff database to ensure the upmost integrity of the system.

Skills

Organizational skills

Communication skills

Regulatory knowledge

Education

Degree in Business or health related field

Certified Provider Credentialing Specialist

Tools

Microsoft Word

Microsoft Excel

Website applications

Job description

CHI Saint Joseph Medical Group in Kentucky is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers in line with delegated agreements and regulatory requirements.

You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the medical staff office to ensure timely completion and compliance of the credentialing processes.