Payer Enrollment & Credentialing Specialist

TeleSpecialists; Fort Myers (FL); On-site; USD 45,000 - 75,000; Full time

Benefits offered by this job

Medical, Dental and Vision benefits

Tuition Reimbursement

Paid Vacation

Leadership Training Classes

Job summary

TeleSpecialists is hiring a Payer Enrollment Team Member to assist facilities with enrolling TeleSpecialists providers with Medicare, state Medicaid and commercial carriers. The role also maintains CAQH, PECOS, and State Medicaid profiles and flags any issues to management.

The position requires payer enrollment experience and familiarity with credentialing software; MD Staff is preferred. Strong attention to detail and ability to manage multiple portals is essential.

Qualifications

• Payer Enrollment experience required.
• Credentialing software experience required; MD Staff preferred.
• Experience with Joint Commission or National Committee for Quality Assurance preferred.

Responsibilities

• Complete initial, reassignment and re-validation applications with Medicare for facilities and providers.
• Complete initial, reassignment and re-validation applications with various state Medicaid programs for facilities and providers.
• Ensure physician Medicare re-validation apps for Commercial networks are completed on time.
• Maintain PECOS portal for providers, including approval of facilities and updating demographic information.
• Manage and maintain NPPES portal for providers.
• Create, update, and maintain CAQH profiles for providers.
• Manage Practice Manager CAQH profile for all providers and facilities.
• Manage password updates for various enrollment portals (CAQH, Medicare, Medicaid).
• Update MD Staff with the progress of all activities.
• Complete facility payer enrollment paperwork for providers and return to the facility promptly.
• Manage Availity portal for various insurance networks.

Skills

Payer enrollment

Medicare enrollment

Customer coordination

Tools

MD Staff

CAQH

PECOS

Job description

TeleSpecialists is hiring a Payer Enrollment Team Member to assist facilities with enrolling TeleSpecialists providers with Medicare, state Medicaid and commercial carriers. The role also maintains CAQH, PECOS, and State Medicaid profiles and flags any issues to management.

The position requires payer enrollment experience and familiarity with credentialing software; MD Staff is preferred. Strong attention to detail and ability to manage multiple portals is essential.