Credentialing Pro: Payer Enrollment & Ops Lead

CommonSpirit Health; London (KY); On-site; USD 27,000 - 39,000; Full time

Job summary

CommonSpirit Health in Kentucky is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers. You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the hospital medical staff office to ensure timely completion of delegated credentialing processes.

You will apply thorough knowledge of credentialing regulations, possess strong organizational and communication skills,

Qualifications

• Degree in Business or health related field needed.
• Experience with Microsoft Word, Excel, and Website applications.

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

Education

Degree in Business or health related field

Tools

Microsoft Word

Excel

Website applications

Job description

CommonSpirit Health in Kentucky is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers. You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the hospital medical staff office to ensure timely completion of delegated credentialing processes.

You will apply thorough knowledge of credentialing regulations, possess strong organizational and communication skills,