Credentialing Enrollment Specialist

Job not on LinkedIn

🕒 August 12

🇺🇸 United States – Remote

💵 $24 - $36 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 38%

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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Advocate Aurora Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $10.2M Grant on 2019-08

Healthcare • Healthcare Insurance

Advocate Aurora Health is a leading healthcare organization that operates across various regions including Central Chicagoland, Central Wisconsin, Greater Milwaukee, and more. With a diverse range of career areas such as advanced practice clinicians, behavioral health, nursing, and more, Advocate Aurora Health is committed to helping people live well. The organization offers numerous benefits and opportunities for career advancement, fostering an environment where individuals can thrive and innovate in the healthcare sector. Advocate Aurora Health prioritizes the safety of its candidates and maintains a robust recruitment process to protect sensitive information.

📋 Description

• Perform primary source verifications for managed care credentialing and re-credentialing of MGD providers • Resolve and support billing issues related to provider enrollment and credentialing • Enter provider data into the ECHO database and provide applicant-status feedback to System entities • Follow up on expired licenses, board certifications, insurance, and DEA registrations • Prepare physician files for managed care, compliance, and accreditation audits • Conduct practice site visits for MGD practices • Facilitate timely and accurate information flow to Managed Care Organizations and the System • Review provider directories and other managed-care information for demographic and participation accuracy • Support the CPN Credentialing and Quality Review Committee

🎯 Requirements

• High school diploma or GED required • Bachelor's degree preferred • Three years' experience in provider credentialing, privileging, and/or enrollment in a hospital, managed care plan, or CMS environment required • Knowledge of and experience with personal computers, Windows, and Microsoft applications required • Knowledge of copier and fax machines and multi-line telephone required • Experience in typing, word processing, and business correspondence required • NAMSS CPCS or CPMSM certification preferred • Frequent verbal and written communication in English required • Occasional travel to other corporate offices • Personal vehicle required • Intact sense of sight and hearing required • Ability to perform duties involving sitting, standing, walking, repetitive wrist/arm motion, and lifting 20–50 pounds

🏖️ Benefits

• Comprehensive Total Rewards benefits and well-being programs • Competitive compensation • Generous retirement offerings • Premium pay such as shift and on-call pay, based on position • Incentive pay for select positions • Opportunity for annual increases based on performance • Paid Time Off programs • Medical, dental, vision, life, and short- and long-term disability benefits • Flexible Spending Accounts for eligible health care and dependent care expenses • Adoption assistance • Paid parental leave • Defined contribution retirement plans with employer match • Other financial wellness programs • Educational Assistance Program