Remote Credentialing & Enrollment Specialist

Intermountain Healthcare Inc.; Madison (WI); Remote; USD 31,000 - 47,000; Full time

Job summary

Intermountain Health is seeking a Credentialing/Enrollment Specialist to coordinate and manage all aspects of provider enrollment and re-enrollment across commercial and government payers. You will collaborate with care teams and payers to ensure timely, accurate credentialing and data maintenance.

Ideal candidates have experience in healthcare revenue cycle, strong attention to detail, and excellent communication skills.

Qualifications

• High School graduate or equivalent is required
• One year experience in a healthcare revenue cycle setting
• Preferred experience with provider enrollment/credentialing

Responsibilities

• Responsible for ensuring timely and accurate facility, medical group, and individual government enrollments for technical and professional fee claim reimbursement.
• Coordinates provider enrollment with commercial and government payers for an entire market, ensuring timely and accurate enrollment.
• Data entry of expirables, locations, and payer enrollment information in the payer enrollment database.
• Assist with initial and re-enrollment applications for local and national payers via portals or other methods.
• Follow up with payers to obtain enrollment status and resolve issues.
• Support providers and client personnel with enrollment applications and carrier communications.
• Facilitate CAQH applications setup, attestation, and maintenance.
• Participate in enrollment progress update meetings and communicate status to stakeholders.
• Submit provider changes to health plans and inform stakeholders of updates.
• Collaborate with AR and Coding to identify denial trends and opportunities for improvement.
• Lead enrollment and provider/payer projects including clinic acquisitions and onboarding/offboarding.

Skills

Computer literacy

Microsoft Office

Communication

Organizational Skills

Attention to Detail

Accountability/ability to work indip…

Customer Service

Medical billing and collections

Medical terminology

Education

High School Diploma or Equivalent

One year healthcare revenue cycle experience

Job description

Intermountain Health is seeking a Credentialing/Enrollment Specialist to coordinate and manage all aspects of provider enrollment and re-enrollment across commercial and government payers. You will collaborate with care teams and payers to ensure timely, accurate credentialing and data maintenance.

Ideal candidates have experience in healthcare revenue cycle, strong attention to detail, and excellent communication skills.