Provider Enrollment & Credentialing Specialist

Innovaccer; United States; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Generous Paid Time Off

Best-in-Class Parental Leave

Recognition & Rewards

Comprehensive Insurance Coverage

Job summary

Innovaccer Inc. seeks a Provider Services Specialist to manage enrollment tasks and follow up on credentialing holds and denials for large multi-specialty healthcare clients. You will escalate, track, and trend payer, provider, or billing issues and liaise with practitioners and carriers.

The role requires 3+ years in credentialing/enrollment, HIPAA-compliant medical billing experience, and strong MS Office skills, with Athena exposure. Bachelor's degree or equivalent experience preferred.

Qualifications

• 3+ years of credentialing and enrollment experience.
• Experience in a medical billing environment with HIPAA compliance.
• Athena experience required.
• Bachelor’s degree preferred or equivalent experience.
• Proficient in MS Office Suite.

Responsibilities

• Demonstrates a thorough knowledge and proficiency in all aspects of provider enrollment in a professional healthcare practice setting.
• Provides support on front end holds and back-end denials with a goal of follow up and resolution.
• Reports on new and existing issues to upper administration.
• Processes tasks from Enrollment Worklist including Credentialing Status, Payer Affiliation, Forms, and Online Enrollments. Assist with EDI, ERA, EFT, and Athena payor portal access
• Updates and maintains all Payer Enrollment groups and statuses as directed by lead or administration.
• Possess a working knowledge and effective navigation of insurance portals including CAQH.
• Acts as liaison with Practitioners, billing management and insurance carriers.
• Performs other assigned duties/tasks.
• Demonstrates mastery of the above essential functions with passing grades in testing environment.

Skills

Athena

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Credentialing databases

Education

Bachelor's degree or equivalent experience

Job description

Innovaccer Inc. seeks a Provider Services Specialist to manage enrollment tasks and follow up on credentialing holds and denials for large multi-specialty healthcare clients. You will escalate, track, and trend payer, provider, or billing issues and liaise with practitioners and carriers.

The role requires 3+ years in credentialing/enrollment, HIPAA-compliant medical billing experience, and strong MS Office skills, with Athena exposure. Bachelor's degree or equivalent experience preferred.