Provider Enrollment & Credentialing Specialist

Intermountain Healthcare Inc.; West Valley City (UT); On-site; USD 31,000 - 47,000; Full time

Job summary

Intermountain Health in West Valley City, Utah, seeks an Enrollment and Credentialing Specialist to coordinate provider enrollment, credentialing and related administrative functions for the Medical Staff and affiliated professionals.

The role supports enrollment with commercial and government payers, completes re-credentialing tasks, maintains payer portals, and collaborates with AR and Coding to resolve denials. Requires attention to detail and healthcare revenue cycle experience.

Qualifications

• High School diploma or equivalent required.
• One year experience in a healthcare revenue cycle setting.
• Preferred: experience with government payers and/or commercial payers in a revenue service setting.
• Preferred: knowledge of working medical billing database work queues.

Responsibilities

• Participates in enrollment progress update meetings and provides status to stakeholders.
• Completes payer re-credentialing requests and demographic/roster requests.
• Completes out-of-State Medicaid enrollments for assigned States.
• Coordinates enrollment with commercial and government payers for the market; ensures timely and accurate enrollment.
• Data entry of expirables, practice/billing locations, and payer enrollment information.
• Submit provider enrollment applications for local and national payers via portals or other methods.
• Follow up with payers to monitor application status and resolve issues.
• Assist providers with applications and CAQH attestations.
• Collaborates with AR to identify denial trends and with Coding on CPT-code related denials.

Skills

Computer literacy

Microsoft Office

Communication (oral and written)

Organizational Skills

Attention to Detail

Accountability/ability to work indipd

Customer Service

Knowledge of medical billing and six

Medical terminology

Education

High School Diploma or Equivalent

Job description

Intermountain Health in West Valley City, Utah, seeks an Enrollment and Credentialing Specialist to coordinate provider enrollment, credentialing and related administrative functions for the Medical Staff and affiliated professionals.

The role supports enrollment with commercial and government payers, completes re-credentialing tasks, maintains payer portals, and collaborates with AR and Coding to resolve denials. Requires attention to detail and healthcare revenue cycle experience.