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Ennoble Care · 1 day ago

Credentialing Specialist (Remote)

United States

Full-time

Remote

Mid Level

3+ years exp

Ennoble Care is a mobile primary care, palliative care, and hospice service provider dedicated to delivering high-quality care to patients with chronic conditions and limited mobility. The Credentialing Specialist is responsible for managing the credentialing application process, ensuring timely execution of provider enrollments, and maintaining communication with providers and teams to resolve any issues related to enrollment status.

Health CareMental Health

Responsibilities

Prepare new and existing provider enrollment applications and/or written link letters

Create and submit new group enrollment applications when contracts are executed

Follow up timely with payers on submitted applications/letters for approval notices

Ensure timely revalidation of all providers and groups

Communicate with providers and other team members to resolve payer issues and confirm participating status

Manage all documentation in an organized manner – upload documentation to a shared drive and update Modio

Track all provider licensure and communicate with provider prior to expiration

Complete, update and maintain CAQH profiles for providers

Identify and communicate any potential enrollment issues that could result in loss of revenue

Establish relationships and maintain communication with provider representatives

Set up provider portals and maintain access for team members as needed

Participate in team meetings and communications

Perform specific assignments as directed by the Revenue Cycle Director

Qualification

Provider enrollment experiencePayer processesRegulatory compliance knowledgeModio Health experienceMicrosoft Office proficiencyCustomer serviceMultitasking abilityDetail orientedInterpersonal skillsOrganizational skills

Required

Maintain regulatory requirements, including all federal, state, local regulations and accrediting organization standards

Knowledge of government and commercial payer's enrollment processes and requirements

Minimum 3 years' experience in provider enrollment

Detail oriented, organized and able to multitask

Strong interpersonal and organizational skills

Excellent customer service skills

Able to work in a fast-paced, acquisitional environment

Represent the organization in a positive and professional manner

Demonstrated knowledge and experience working with the provider enrollment

Comply with all organizational policies regarding ethical business practices

Proficient in all Microsoft Office applications

Preferred

Preferred experience with Modio Health

Benefits

Medical, Dental, Vision and supplementary benefits such as Life Insurance, Short Term and Long Term Disability, Flexible Spending Accounts for Medical and Dependent Care, Accident, Critical Illness, and Hospital Indemnity.

Paid Time Off

Paid Office Holidays

Paid Sick Time

401(k) with up to 3% company match

Referral Program

Payactiv: pay-on-demand. Cash out earned money when and where you need it!