Provider Enrollment & Credentialing Specialist - Hybrid

Socket.dev; Wakefield (MA); Remote; USD 34,000 - 52,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Credentialing Specialist to facilitate enrollment of providers and manage credentialing across health plans.

You will compile enrollment packets, recredential providers every two years, input data, and communicate with plans and BIDCO staff to ensure timely enrollment.

Qualifications include 1–3 years of related experience, a High School diploma or GED, and proficiency with Microsoft Office.

Qualifications

• High School diploma or GED required.
• Bachelor's degree preferred.
• 1–3 years related work experience required.
• Provider Enrollment experience is strongly preferred.

Responsibilities

• Facilitates timely enrollment of new providers in health plans and existing providers in newly contracted health care plans.
• Compiles accurate health plan application packets and reviews for accuracy before submission.
• Performs recredentialing of BIDCO providers every 2 years and tracks progress to target dates.
• Inputs enrollment information into the provider database and maintains data accuracy.
• Communicates with health plans, clinicians and BIDCO staff; develops reporting to track enrollment status.
• Maintains relationships with provider practices and health plan contacts to resolve enrollment issues.
• Assists in processing applications for new BIDCO group entities and coordinates with hospitals for privileges.
• Facilitates delegated credentialing in coordination with Professional Staff Affairs offices.

Skills

Provider Enrollment

Microsoft Office

Data entry

Communication

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Outlook

Excel

Word

Job description

Beth Israel Lahey Health is seeking a Credentialing Specialist to facilitate enrollment of providers and manage credentialing across health plans.

You will compile enrollment packets, recredential providers every two years, input data, and communicate with plans and BIDCO staff to ensure timely enrollment.

Qualifications include 1–3 years of related experience, a High School diploma or GED, and proficiency with Microsoft Office.