Provider Credentialing Specialist

Job Summary

A company is looking for a Provider Credentialing Specialist II to provide enrollment support to clinical providers and maintain provider enrollments.

Key Responsibilities

• Submits and processes initial and re-enrollment applications to payers
• Maintains accuracy of provider NPPES and CAQH accounts and follows up on outstanding enrollment information
• Tracks enrollment applications with payers and ensures compliance with deadlines

Required Qualifications

• High School graduate or equivalent; AS or B.S. degree in business administration or healthcare related field is a plus
• Previous enrollment experience with Medicare and Medicaid preferred
• Knowledge of enrollment processes and Medicare/Medicaid standards
• Proficient in computer applications including MS Word, MS Excel, and database administration
• Ability to work independently and manage time effectively in a fast-paced environment