Health Plan Credentialing/Payer Enrollment Specialist
Catalyst Consulting - The Business of Medicine, Austin, TX, United States
Job Posting: Health Plan Credentialing/Payer Enrollment Specialist
Location:
Austin, TX
Employment Type:
Full-time
Salary Range:
Competitive Based on Experience
Position Overview
The Provider Enrollment Specialist is responsible for managing and coordinating the credentialing and enrollment process for healthcare providers across various payers. The ideal candidate will have excellent organizational skills, strong attention to detail, and a deep understanding of credentialing requirements and payer-specific processes.
Key Responsibilities
Credentialing Management:
Prepare, review, and submit credentialing applications for healthcare providers with commercial and government payers.
Maintain up-to-date provider information in credentialing databases and systems.
Track application statuses and follow up with payers to ensure timely approval.
Manage enrollment processes for new providers and facilities with Medicare, Medicaid, and private insurance plans.
Coordinate updates to provider rosters, including changes in practice locations, group affiliations, and tax IDs.
Communication and Support:
Serve as a liaison between providers and payers to resolve credentialing and enrollment issues.
Data Management:
Maintain accurate and organized files for all credentialing and enrollment activities.
Regularly update databases with provider information and application statuses.
Qualifications
Minimum of two years of experience in healthcare credentialing and provider enrollment.
Knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
Familiarity with credentialing software (e.g., CAQH, PECOS, or payer-specific portals).
Exceptional attention to detail and organizational skills.
Strong communication skills, both written and verbal.
Ability to multitask and meet deadlines.
Why Join Us
Competitive salary and benefits package.
Opportunity to work with a dedicated and supportive team.
Professional development and growth opportunities.
Remote work and flexible hours.
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Location:
Austin, TX
Employment Type:
Full-time
Salary Range:
Competitive Based on Experience
Position Overview
The Provider Enrollment Specialist is responsible for managing and coordinating the credentialing and enrollment process for healthcare providers across various payers. The ideal candidate will have excellent organizational skills, strong attention to detail, and a deep understanding of credentialing requirements and payer-specific processes.
Key Responsibilities
Credentialing Management:
Prepare, review, and submit credentialing applications for healthcare providers with commercial and government payers.
Maintain up-to-date provider information in credentialing databases and systems.
Track application statuses and follow up with payers to ensure timely approval.
Manage enrollment processes for new providers and facilities with Medicare, Medicaid, and private insurance plans.
Coordinate updates to provider rosters, including changes in practice locations, group affiliations, and tax IDs.
Communication and Support:
Serve as a liaison between providers and payers to resolve credentialing and enrollment issues.
Data Management:
Maintain accurate and organized files for all credentialing and enrollment activities.
Regularly update databases with provider information and application statuses.
Qualifications
Minimum of two years of experience in healthcare credentialing and provider enrollment.
Knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
Familiarity with credentialing software (e.g., CAQH, PECOS, or payer-specific portals).
Exceptional attention to detail and organizational skills.
Strong communication skills, both written and verbal.
Ability to multitask and meet deadlines.
Why Join Us
Competitive salary and benefits package.
Opportunity to work with a dedicated and supportive team.
Professional development and growth opportunities.
Remote work and flexible hours.
#J-18808-Ljbffr