Provider Credentialing & Enrollment Specialist

Beacon Health System; Granger (IN); On-site; USD 65,000 - 90,000; Full time

Job summary

Beacon Health System is seeking a Provider Enrollment & Credentialing Associate who will ensure timely credentialing for Beacon Medical Group physicians and affiliated providers across the system. You will coordinate with CHA, CVO Alliance, payors, and hospitals to meet NCQA standards and departmental policies.

You will develop systems to review credentialing applications, maintain CAQH profiles, prepare acceptance letters, report deficiencies, and support provider onboarding with accurate

Qualifications

• High school diploma or equivalent; associate degree preferred.
• Three years of credentialing experience in healthcare or health insurance preferred.
• Knowledge of NCQA standards and credentialing processes.

Responsibilities

• Coordinate credentialing with outside agencies, payors, office managers, and contracted providers.
• Complete credentialing according to NCQA/payor standards and departmental policies.
• Prepare letters of acceptance and report deficiencies.
• Serve as liaison with CHA Medical Director on credentialing status.
• Attend CHA Credentialing Committee meetings and prepare charts/minutes.
• Develop systems to review CHA-contracted facilities credentialing.
• Complete Primary Source Verifications for CVO Alliance customers.
• Schedule and monitor delegation audits for CHA and CVO Alliance.
• Notify relevant entities of physician/provider credentialing timelines.
• Maintain Beacon Health System provider information in ECHO database.
• Educate new physicians/providers on licensure deadlines.
• Assist with network and claim issues related to credentialing.

Skills

Analytical skills

Problem-solving

Organization

Communication

Interpersonal

Basic math

Microsoft Office

Data entry

Education

High school diploma or equivalent

Associate's Degree in Business/Health Administration or related field

Tools

CAQH

Microsoft Office

Spreadsheets

Credentialing databases

Job description

Beacon Health System is seeking a Provider Enrollment & Credentialing Associate who will ensure timely credentialing for Beacon Medical Group physicians and affiliated providers across the system. You will coordinate with CHA, CVO Alliance, payors, and hospitals to meet NCQA standards and departmental policies.

You will develop systems to review credentialing applications, maintain CAQH profiles, prepare acceptance letters, report deficiencies, and support provider onboarding with accurate