Credentialing and Provider Enrollment Specialist
Catalyst Consulting, a nationally recoganized medical practice consulting firm, has been servicing medical clients across the nation for over 23 years as they start and grow their practices. We are expanding and looking for individuals who would like to work for a growing consulting business that offers a highly sought after “lifestyle job” which allows for flexible hours, remote work, an open-door policy, and a friendly and supportive work environment with opportunities to grow with us. We are not a corporate backed organization with the requirements and limitations that come with that. If you are a motivated self-starter who appreciates the freedom to do your job, with the support of a management team who has worked their way into management by starting with the basics and working their way up – this position is right for you!
What will I be responsible for in this job?
The Credentialing Specialist is responsible for obtaining and coordinating all necessary provider enrollment applications to Government and Commercial payers while maintaining up-to-date data for each provider in credentialing databases and online systems.
Responsibilities Included but are not limited to:
· Compiles and maintains current and accurate data for all providers
· Completes providers initial credentialing submission to join payer network and monitors applications and follows-up as needed
· Procurement of payer agreements and follow through to loading
· Maintains copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers
· Sets up and maintains provider information in Catalyst credentialing database as well as online systems (i.e. CAQH, PECOS, PEMS)
· Ensures practice addresses are current with health plans
· Maintains ongoing knowledge of current health plan requirements for credentialing providers
· Must have at least 2 years previous knowledge or experience with payer enrollment
· PECOS, CAQH, and previous online enrollment experience
· Computer proficiency with intermediate MS Office skills
· High school diploma
· Minimum of 45-50 WPM typing skills
· Good decision-making, analytical, and problem-solving skills
· Excellent verbal and written communication skills
· Ability to research and analyze data.
· Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
· Self-starter with ability to work independently and as part of a team
· Must be able to identify and proactively organize tasks to ensure completion within department timelines and goal
· Excellent attention to detail
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