Senior Enrollment Specialist – Credentialing

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Caris Life Sciences

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2008

🧬 Biotechnology

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

Biotechnology • Healthcare Insurance • Artificial Intelligence

Caris Life Sciences is a leading innovator in the field of molecular science, focusing on providing cancer patients and oncologists with comprehensive molecular information to revolutionize cancer care. The company specializes in precision medicine, using advanced technologies like molecular profiling and artificial intelligence to understand cancer at a molecular level, offering better treatment options for patients. Caris Life Sciences integrates these technologies with clinical trial solutions and biopharma to enhance cancer research and treatment solutions. Their commitment is to improve as many lives as possible through transformative medical science.

📋 Description

• Responsible for overseeing, monitoring, and maintaining the processes involved in both initial and revalidation of payer enrollment applications. • Possess a thorough comprehension of payer enrollment requirements and regulations governing enrollment to ensure ongoing compliance. • Responsible for securing timely enrollment by submitting applications ahead of deadlines and maintaining consistent follow-up with payers through completion. • Conduct research and document enrollment processes encompassing, but not limited to, initial enrollment, revalidation, and demographic changes. • Regularly update and manage data in the credentialing database, spreadsheets, and folders, while maintaining data integrity. • Assures compliance with payer requirements as related to the provider enrollment and monitor activities to ensure compliance with all procedures and regulations. • Participate in the development and implementation of credentialing processes and procedures and provide input regarding process improvement. • Serve as primary contact for payer inquiries and issue resolution, specifically related to enrollment and credentialing matters. • Assist in the training of colleagues on internal enrollment policies and procedures and provide guidance on navigating payer agencies requirements.

🎯 Requirements

• High school diploma or GED required. • Four to six years of experience in a credentialing office or equivalent related environments. • Knowledge of health plan and governmental payer credentialing process and requirements, such as NCQA/state/federal standards, Medicaid, and Medicare. • Demonstrates proficient communication abilities, both orally and in writing, and strong interpersonal skills. • Exhibits a heightened level of awareness and attention to detail. • Demonstrates outstanding organizational and time management skills. • Demonstrate the ability to work autonomously while effectively contributing to a collaborative team environment. • Ability to maintain confidentiality. • Proficient in Database, MS Excel, Word, Adobe and other software systems. • A team player with multi-tasking capability and strong customer service orientation.

🏖️ Benefits

• Highly competitive and inclusive medical, dental and vision coverage options • Health Savings Account for medical expenses and dependent care expenses • Flexible Spending Account to pay for certain out-of-pocket expenses • Paid time off, including: vacation, sick time and holidays • 401k match and Financial Planning tools • LTD and STD insurance coverages, as well as voluntary benefit options • Employee Assistance Program • Pet Insurance • Legal Assistance • Tuition Assistance