Piedmont Urgent Care by WellStreet Hiring for Credentialing Specialist/ Provider Enrollment Specialist at Remote Full Time

Credentialing & Enrollment Specialist

The Credentialing & Enrollment Specialist will review/submit applications, verify provider credentials, maintain records of verification and update databases as needed. This role will proactively manage the credentialing process to ensure appropriate and timely credentialing to meet the needs of WellStreet Urgent Care.

Duties and Responsibilities

• Carefully review enrollment and credentialing applications to assure information is accurate and complete before submission to Medicare, Medicaid, or JV Health systems
• Perform primary source verifications in timely manner (24-48 hours when possible)
• PSV’s include AMA, Board Certifications, student clearinghouse, License verification(s), OIG/SAM, NPI,
• NPDB & DEA & to supervisor and RMD any derogatory information ASAP
• Ensure all documentation for credentialing is up to date & save supporting documents to databases appropriately
• Facilitate and track enrollment paperwork and applications to and from providers to enroll before their start date
• Maintain complete and accurate provider credentialing files and update credentialing software system with all information and updates as needed
• Monitor and notify providers of upcoming expirables, including expiring privileges, licensures, board certifications, MOC requirements and all other state and national required documents necessary for the practitioner to perform under their scope of practice legally and ethically
• Maintain and update the credentialing database: Notes of work performed & communication attempts, update cred cycle information, enrollment status
• Establish and maintain professional working relationships with providers and medical staff service departments
• Provide weekly status updates to team lead, supervisor and/or Regional Medical Directors to ensure goals are met to maintain alignment across all parties
• Demonstrate exemplary customer service to our providers and facilities
• Meet targeted credentialing deadlines and start dates
• Proactively foster relationships with all departments and leaders to be identified as trusted RCM resource
• Support all other functions of the Revenue Cycle Team as needed

Please apply using the link below.

https://recruiting.ultipro.com/WEL1014WELS/JobBoard/f7d57595-9140-408f-8a1b-fc9ca6631fad/Opportunity/OpportunityDetail?opportunityId=900a455c-f8c4-4ca2-98ca-2131201a2423&sourceId=78eaf008-dc25-4614-bcfe-5e2f3be2ba58

Job Type: Full-time

Pay: From $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• NCQA standards: 3 years (Preferred)
• Medical Credentialing: 3 years (Required)
• Medical terminology: 3 years (Preferred)
• License Verifications: 3 years (Preferred)
• Revenue cycle management: 3 years (Required)

Work Location: Remote