Credentialing Enrollment Specialist

American Addiction Centers•Charlotte, NC

3d•$24 - $36•Remote

About The Position

The Credentialing Enrollment Specialist will oversee internal processes, procedures, and governmental/regulatory requirements for the timely and accurate completion and submission of provider applications. This role assists in departmental planning, development, and organization. The position is remote and full-time, operating during normal business hours.

Requirements

High school diploma or GED required.
Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment is required.
Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone required.
Experience in typing, word processing, and business correspondence is required.
Use of personal vehicle required.
Intact sense of sight and hearing required.

Nice To Haves

Bachelor's degree preferred.
Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred.

Responsibilities

Performs primary source verifications of documentation required for managed care credentialing and re-credentialing of MGD providers.
Provides issue resolution and support regarding billing issues as they relate to provider enrollment and credentialing for MGD providers and the Central Billing Office.
Enters provider data in the ECHO database according to established departmental processes and provides feedback to other System entities as to the status of the applicants.
Performs follow-up on needed information (expired licenses, board certifications, insurance, and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner.
Prepares physician files for file audits by managed care organizations, Corporate Compliance, and accreditation entities.
Conducts practice site visits for practices within MGD.
Facilitates communication tools and/or activities to maintain timely and accurate flow of information to Managed Care Organizations (MCOs) and the System.
Reviews hard copy and electronic provider directories and other information produced by managed care organizations reflecting MGD and the System's demographics and participation.
Provides Team member support to the CPN Credentialing and Quality Review Committee.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program