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Sentara Healthcare Inc

Credentialing Specialist I

Sentara Healthcare Inc, Norfolk, Virginia, United States, 23500

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Sentara Health is hiring a Payor Enrollment Credentialing Specialist I for the Provider Credentialing Department. This is a

Full-time, 40 hours per week

Day shift position Mon-Fri between the hours of 7:00am-5:00pm.

The position is located in VA or could be remote – work from home is available only in these states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming

Responsible for ensuring that healthcare professionals and providers meet the necessary qualifications and comply with all regulatory and accreditation standards. This role involves gathering and verifying a variety of documents and information, coordinating with healthcare providers, and maintaining accurate and up-to-date credentialing files.

Education

High School Diploma

Certification/Licensure

CPCS - Certified Provider Credentialing Specialist (Preferred)

Experience

Requires thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 1 year of directly related experience. Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).

Keywords: Talroo-Health Plan, Monster, LinkedIn, Credential Stream, excel, data analysis, accounts receivable, Epic, revenue cycle, billing, provider not enrolled denials, appeals, onboarding, MPI, CAQH, CVO, MCO, HMO or Hospital Based Credentialing (MSO).

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