Provider Enrollment & Credentialing Specialist (Hybrid)

CH_050 Cayuga Medical Center at Ithaca, Inc.; Hayts Corner (NY); Hybrid; USD 34,000 - 45,000; Full time

Job summary

The Provider Enrollment Specialist at Cayuga Health is responsible for the initial and ongoing maintenance of provider and organization data, and for completing enrollment applications per internal policies and payer requirements to ensure network compliance. The role acts as a liaison among the Cayuga Health Partners Network, Centralus Health, providers and plans.

The role also builds relationships with practice billing/credentialing staff and payer representatives, supporting timely enrollment

Qualifications

• Associate's degree required.
• 2-5 years of provider enrollment or credentialing experience.
• Licensure not required.

Responsibilities

• Perform provider enrollment activities as necessary.
• Manage completion and submission of enrollment applications for CHP providers.
• Understand payer requirements and required forms and documentation.
• Verify information on enrollment documents, including licensure and insurance.
• Follow up with physicians/providers on missing enrollment details.
• Maintain Provider Data Management System and provider rosters.

Skills

Enrollment experience

Credentialing experience

Notary Public certification

Education

Associate's degree

Job description

The Provider Enrollment Specialist at Cayuga Health is responsible for the initial and ongoing maintenance of provider and organization data, and for completing enrollment applications per internal policies and payer requirements to ensure network compliance. The role acts as a liaison among the Cayuga Health Partners Network, Centralus Health, providers and plans.

The role also builds relationships with practice billing/credentialing staff and payer representatives, supporting timely enrollment