Provider Credentialing & Enrollment Specialist

3M HEALTHCARE; Greenville (SC); Remote; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

PTO

401K with match

Continuing Education Allowance

Life Insurance

Short/Long Term Disability

Maternity/Paternity leave

Mental Health day

Calm subscription

Job summary

Crossroads Treatment Centers seeks a Provider Enrollment Coordinator to support onboarding and credentialing for new and existing providers. The role partners with COL and recruiting to ensure timely enrollment and credentialing updates for the Credentialing Committee.

Responsibilities include maintaining CAQH/NPPES/PECOS records, preparing payer paperwork, and collaborating with payors and internal teams to resolve issues across states.

Qualifications

• Minimum of 2 years in physician credentialing and/or enrollment.
• Experience with provider credentialing databases/websites/portals (CAQH, NPPES, PECOS).
• Familiarity with Modio software.
• Understanding of the revenue cycle process.
• Overtime may be required.

Responsibilities

• Receives notifications from COL and collaborates with recruiting during onboarding.
• Maintain provider credentialing documents for new and existing providers.
• Provide credentialing updates for Credentialing Committee reviews.
• Prepare payer paperwork and enroll providers/facilities in multiple states.
• Conduct payer research and maintain credentialing databases (CAQH, NPPES, PECOS).
• Escalate credentialing or payor issues to the Director as needed.
• Meet monthly with health plans to obtain statuses and address denials.

Skills

Provider enrollment

Credentialing

CAQH

NPPES

PECOS

Modio

Revenue cycle

Data tracking

Tools

Modio

CAQH

NPPES

PECOS

Job description

Crossroads Treatment Centers seeks a Provider Enrollment Coordinator to support onboarding and credentialing for new and existing providers. The role partners with COL and recruiting to ensure timely enrollment and credentialing updates for the Credentialing Committee.

Responsibilities include maintaining CAQH/NPPES/PECOS records, preparing payer paperwork, and collaborating with payors and internal teams to resolve issues across states.