Enrollment & Credentialing Specialist — Hybrid/Remote

Beth Israel Lahey Health; Wakefield (MA); On-site; USD 71,635,000 - 108,886,000; Full time

Job summary

Beth Israel Lahey Health (BILH) is seeking a Provider Enrollment professional to manage enrollment and recredentialing across multiple health plans for BIDCO providers. You will handle data, document preparation, and liaison activities with plans.

Responsibilities include compiling packets, managing recredentialing cycles every two years, and maintaining provider databases. Excellent Microsoft Office skills and healthcare credentialing knowledge are essential for success in this role.

Qualifications

• High School diploma or GED required.
• Bachelor’s degree preferred.
• 1-3 years related work experience required.
• Provider Enrollment experience is strongly preferred.
• Advanced skills with Microsoft applications including Outlook, Word, Excel, PowerPoint or Access and other web-based applications.

Responsibilities

• Facilitates timely enrollment of new providers in health plans and existing providers in newly contracted health care plans including compilation of confidential data.
• Compiles accurate health plan application packets for BIDCO Members, reviewing for accuracy before submission to health plans.
• Performs recredentialing of BIDCO providers every 2 years to ensure continued billing eligibility and tracks progress toward target dates.
• Inputs enrollment information into the provider database at initial enrollment and for ongoing changes, maintaining accuracy and uniform nomenclature.
• Communicates with health plans, clinicians and BIDCO staff; develops reporting to keep providers and administrators informed of enrollment status and timelines.
• Develops and maintains strong working relationships with provider practices and health plan contacts; investigates and resolves enrollment problems impeding billing and reimbursement.
• Assists Administrator in processing applications with health plans for new BIDCO group entities and coordinates hospital privileges and documents for onboarding.
• Facilitates delegated credentialing processes in coordination with affiliated Professional Staff Affairs offices.

Skills

Microsoft Office

Education

High School diploma or GED

Bachelor’s degree preferred

Job description

Beth Israel Lahey Health (BILH) is seeking a Provider Enrollment professional to manage enrollment and recredentialing across multiple health plans for BIDCO providers. You will handle data, document preparation, and liaison activities with plans.

Responsibilities include compiling packets, managing recredentialing cycles every two years, and maintaining provider databases. Excellent Microsoft Office skills and healthcare credentialing knowledge are essential for success in this role.