Provider Credentialing & Enrollment Specialist

PATH (People Assisting The Homeless) (Old); Skowhegan (ME); On-site; USD 31,000 - 53,000; Full time

Job summary

PATH (People Assisting The Homeless) (Old) in Skowhegan, ME seeks a Credentialing Representative to manage Medicare PECOS, MaineCare MIHMS, and RFGH NPI site enrollments. You will coordinate credentialing for 96+ providers with commercial, state, and federal insurers to ensure timely claim payments and complete annual re-credentialing.

The role requires a minimum high school education; an associate degree is preferred, with prior credentialing experience favorable.

Qualifications

• The Credentialing Representative must have a minimum of a high school education, Associate Degree preferred.
• Previous experience in a similar role preferred.

Responsibilities

• Set up and maintain Medicare PECOS website, MaineCare MIHMS site, RFGH NPI sites, I&A site.
• Enroll all RFGH providers with contracted commercial, state and federal insurances.
• Ensure payment of all claims to RFGH.
• Perform annual re-credentialing with all contracted commercial insurances.

Education

High school diploma

Associate degree

Job description

PATH (People Assisting The Homeless) (Old) in Skowhegan, ME seeks a Credentialing Representative to manage Medicare PECOS, MaineCare MIHMS, and RFGH NPI site enrollments. You will coordinate credentialing for 96+ providers with commercial, state, and federal insurers to ensure timely claim payments and complete annual re-credentialing.

The role requires a minimum high school education; an associate degree is preferred, with prior credentialing experience favorable.