Provider Credentialing & Enrollment Specialist

Catawba Valley Health System; Conover (NC); On-site; USD 55,000 - 75,000; Full time

Job summary

Catawba Valley Medical Center is seeking a Provider Enrollment Specialist to manage enrollment and re-enrollment for providers with contracted payers and government programs. You will serve as a liaison to resolve credentialing issues and ensure timely submission of all applications with payer contacts and employed physicians.

The role requires a Bachelor's degree or equivalent experience in managed care or revenue cycle, and familiarity with CAQH, PECOS, and NCTracks.

Qualifications

• Bachelor's degree or 4 years' experience in managed care, credentialing, or revenue cycle.
• Advanced knowledge of all Microsoft Office products.
• One year of applicable experience. If candidate has no experience, they must have completed a successful healthcare or finance-oriented internship with good references or at least four years working in managed care, credentialing or revenue cycle.
• Experience in problem-solving, critical thinking, and accomplishing tasks on assigned timelines. Strong understanding of provider credentialing. Working knowledge of CAQH, PECOS and NCTracks. Ability to work independently.

Responsibilities

• Perform enrollment and re-enrollment functions for providers with contracted insurance carriers and government payers.
• Serve as a resource and liaison to implement and resolve issues related to enrollment credentialing.
• Work directly with payer contacts and employed physicians to ensure all applications are completed within specified time periods.

Skills

Problem-solving

Critical thinking

Independent work

Education

Bachelor's degree or 4 yrs experience in managed care/credentialing

Tools

CAQH

PECOS

NCTracks

Microsoft Office

Job description

Catawba Valley Medical Center is seeking a Provider Enrollment Specialist to manage enrollment and re-enrollment for providers with contracted payers and government programs. You will serve as a liaison to resolve credentialing issues and ensure timely submission of all applications with payer contacts and employed physicians.

The role requires a Bachelor's degree or equivalent experience in managed care or revenue cycle, and familiarity with CAQH, PECOS, and NCTracks.