Strategic Credentialing & Payer Enrollment Manager

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); Vor Ort; USD 72.000 - 100.000; Vollzeit

Zusammenfassung

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Payer Enrollment Manager to oversee enrollment activities for employed and certain contracted providers and groups. You will coordinate payer enrollment, onboarding, and credentialing processes in collaboration with Medical Group, Medical Staff Services, and CAQH.

The role requires strong knowledge of credentialing systems (NPI/PECOS/NC Medicaid), excellent communication, and leadership to train staff and ensure timely enrollments

Qualifikationen

• Associate’s degree required or 4 years’ experience in practice management/administration.
• Experience with credentialing and provider enrollment in a large health system.
• Strong written and verbal English communication; team oriented and results driven.

Aufgaben

• Oversee enrollment activities for employed and selected contracted providers and groups to ensure proper payment.
• Coordinate onboarding of providers and new groups from a payer enrollment perspective with Medical Group and Medical Staff Services.
• Work with CAQH and other organizations on credentialing applications processing.
• Ensure NPI, PECOS, NPPES and NC Medicaid data are consistent across CFV entities.
• Provide quality control and training to staff to ensure timely, accurate enrollment and revalidations.

Kenntnisse

Payer enrollment

Credentialing

Communication

Team leadership

Microsoft Office proficiency

Ausbildung

Associate’s degree

Bachelor’s degree preferred

Tools

CAQH

NPI registry

PECOS

NC Medicaid systems

NPPES

Jobbeschreibung

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Payer Enrollment Manager to oversee enrollment activities for employed and certain contracted providers and groups. You will coordinate payer enrollment, onboarding, and credentialing processes in collaboration with Medical Group, Medical Staff Services, and CAQH.

The role requires strong knowledge of credentialing systems (NPI/PECOS/NC Medicaid), excellent communication, and leadership to train staff and ensure timely enrollments