Payor Credentialing & Enrollment Specialist

Trinity Health; North Carolina; On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical benefits

Retirement match

Generous PTO

Tuition reimbursement

Relocation assistance

DailyPay

Diversity & Inclusion groups

Job summary

Mount Carmel Health System seeks a Credentialing Coordinator to manage credentialing and re-credentialing for a large multi-specialty medical group and multiple hospital facilities. You will coordinate insurance credentialing and enrollment with payers while liaising with providers, operations, revenue cycle, and professional billing teams.

The role requires 3–5 years of office experience, including 2 years in medical billing with Medicare/Medicaid/HMO and commercial plan knowledge.

Qualifications

• Associate degree in a related field with knowledge in practice/medical management.
• 3-5 years of professional office experience, including 2 years of medical billing with understanding of Medicare, Medicaid, HMO and Commercial insurance plans.

Responsibilities

• Coordinate facility privileging and re-privileging processes for Medical Group Providers.
• Facilitate malpractice applications and renewals for all employed providers.
• Submit and track credentialing/enrollment applications with payers.
• Provide follow-up, problem investigation, and resolution support to credentialing teams.

Skills

Credentialing

Enrollment

Medical billing

Medicare/Medicaid knowledge

Office experience

Communication

Education

Associate degree in related field

Job description

Mount Carmel Health System seeks a Credentialing Coordinator to manage credentialing and re-credentialing for a large multi-specialty medical group and multiple hospital facilities. You will coordinate insurance credentialing and enrollment with payers while liaising with providers, operations, revenue cycle, and professional billing teams.

The role requires 3–5 years of office experience, including 2 years in medical billing with Medicare/Medicaid/HMO and commercial plan knowledge.