Remote Credentialing & Payer Enrollment Specialist

Rogers Behavioral Health, Inc.; Town of Oconomowoc (WI); Hybrid; USD 52,000 - 70,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401(k) retirement plan

Employee share program

Life/disability insurance

Flexible spending accounts

Tuition reimbursement

Health and wellness program

Employee assistance program (EAP)

Job summary

Rogers Behavioral Health, Inc. in Wisconsin seeks a Credentialing Specialist to manage facility and practitioner enrollment and maintain provider data across systems. You will ensure HIPAA compliance and coordinate with payer representatives to verify network status and affiliations.

Responsibilities include CAQH data entry, enrolling providers in health plans, and supporting Payer Strategies and Patient Financial Services teams. On-site or remote work options are available to meet clinic needs.

Qualifications

• Associate's degree or 2 years' experience.
• Administrative skills, including computer/word processing.
• Proficiency with Microsoft Office, Adobe and Excel.
• Exceptional critical thinking and sound judgement.
• Excellent written, verbal, and auditory communication.
• Ability to perform on site or remotely.

Responsibilities

• Maintain facility and practitioner enrollment information in multiple systems.
• Answer inquiries regarding provider network status and affiliations.
• Populate CAQH and credentialing data accurately and timely.
• Enroll practitioners in contracted health plans and government payers.
• Collaborate with Payer Strategies and Patient Financial Services teams.
• Assist in process improvements and back-up to related roles.

Skills

Administrative skills

Microsoft Office

Excel

Critical thinking

Written and verbal communication

Auditory skills

Education

Associate's degree

NAMSS/CPCS Certification

Tools

Symplr

CAQH

Job description

Rogers Behavioral Health, Inc. in Wisconsin seeks a Credentialing Specialist to manage facility and practitioner enrollment and maintain provider data across systems. You will ensure HIPAA compliance and coordinate with payer representatives to verify network status and affiliations.

Responsibilities include CAQH data entry, enrolling providers in health plans, and supporting Payer Strategies and Patient Financial Services teams. On-site or remote work options are available to meet clinic needs.