Credentialing and Provider Enrollment Coordinator

Job not on LinkedIn

🕒 3 days ago

🇺🇸 United States – Remote

💵 $41k - $55.5k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Ascension

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

💰 $500M Debt on 2019-11

Healthcare • Non-profit

Ascension is a U. S. -based healthcare organization that connects patients to care across the communities it serves. The company operates hospitals and specialized care sites in multiple states (e. g. , Florida, Illinois, Indiana, Kansas), highlights location-based search for care, and promotes compassionate, community-focused services.

📋 Description

• Complete the day-to-day credentialing and re-credentialing for all providers • Ensure provider files from ACVS meet managed care criteria • Complete state-specific credentialing verifications as necessary • Send newly credentialed rosters to all delegated payers • Complete and submit CAQH applications to all non-delegated payers • Run rosters for all delegated audits • Assist in audits related to credentialing and enrollment • Process provider data updates, changes, and terms in MD Staff and submit them to payers monthly • Follow up with payers to ensure new providers are loaded timely and correctly • Produce required documentation to meet payer and NCQA guidelines • Stay abreast of regulatory, legal, and legislative issues and communicate changes

🎯 Requirements

• High School diploma equivalency OR 1 year of applicable cumulative job-specific experience required • Required professional licensure/certification can be used in lieu of education or experience, if applicable • 2 or 3 years of delegated credentialing experience strongly preferred • 2 or 3 years of health plan experience strongly preferred • Knowledge of managed care criteria, payer requirements, and NCQA guidelines • Ability to complete state-specific credentialing verifications • Ability to complete and submit CAQH applications • Ability to process provider data in MD Staff • Ability to conduct or assist with credentialing/enrollment audits • Ability to monitor regulatory, legal, and legislative requirements

🏖️ Benefits

• Paid time off (PTO) • Various health insurance options & wellness plans • Retirement benefits including employer match plans • Long-term & short-term disability • Employee assistance programs (EAP) • Parental leave & adoption assistance • Tuition reimbursement • Ways to give back to your community