Credentialing and Enrollment Specialist

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🔥 0 minutes ago

🔔 Pennsylvania, Washington – Remote

🔔 Pennsylvania – Remote ☕ Washington – Remote

💵 $30 - $35 / hour

⏱ Part Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Connexin

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

📦 Logistics

🏭 Manufacturing

💰 Venture Round on 2020-09

Consulting • Logistics • Manufacturing

Connexin is a telecommunications company based in Hull, focusing on providing hyperfast broadband services to homes, businesses, and public sectors in Hull and East Yorkshire. Their services include full fiber broadband with speeds up to 5000mbps, smart home solutions via their Connexin SmartHome App, and Internet-of-Things (IoT) technology for smart cities and buildings. Connexin also offers business broadband, skills and training through online courses and bootcamps, and a dedication to social impact through charity work. They pride themselves on customer service, providing local support, and using cutting-edge Wi-Fi 6 technology.

📋 Description

• Manage the full lifecycle of provider and practice enrollment with insurance carriers and health plans, from initial submission through final approval. • Monitor application status and proactively manage renewals to ensure no lapses in coverage, specifically tracking and initiating renewals at least 60 days prior to expiration. • Maintain accurate and current practitioner data in CAQH and other relevant credentialing and data collection websites. • Coordinate directly with medical providers to collect, verify, and organize necessary documentation for application forms. • Facilitate regular meetings with practice stakeholders to provide status updates, performance reporting, and clear communication on overall enrollment progress. • Proactively communicate updates, issues, and approval timelines to both providers and internal leadership. • Troubleshoot enrollment hurdles and resolve issues that may hinder timely participation. • Assist billing teams internally and externally with claims denials related to provider enrollment status. • Perform other duties as assigned.

🎯 Requirements

• Diploma or GED required • Certification through applicable organization a plus • Two (2) or more years of experience in healthcare enrollment, credentialing, or medical practice operations • Demonstrated experience with CAQH and insurance carrier portals • Experience in a role requiring high-volume data collection and stakeholder communication • Exceptional attention to detail and ability to track complex, long-term administrative workflows • Strong verbal and written communication skills, with the ability to lead effective meetings with practice stakeholders • Ability to work independently and manage time effectively to meet 60-day renewal deadlines • Proficiency in maintaining accurate data in CAQH, insurance portals, and internal documentation systems • Strong interpersonal skills for collaborating with medical providers and team leadership.

🏖️ Benefits

• Medical, Prescription, Vision, and Dental Insurance • Life Insurance • 401(k) with company match • Paid Time Off, Holidays, and Volunteer Hours • Company Wellness Program • Employee Assistance Program • Short and Long Term Disability Insurance • Pet Insurance • Tuition Assistance Program • Employee Recognition Program