Credentialing Specialist

🔥 15 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 21%

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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Ennoble Care

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Ennoble Care is a community-based primary, palliative, and hospice care service dedicated to providing care to patients and families. With a mission that emphasizes the honor of caring, Ennoble Care operates across multiple states, including New York, New Jersey, Maryland, DC, Virginia, and Georgia, staffed by licensed clinicians who are committed to delivering exceptional care.

📋 Description

• 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 documentation, upload it to a shared drive, and update Modio • Track provider licensure and communicate with providers before expiration • Complete, update, and maintain CAQH profiles for providers • Identify and communicate 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

🎯 Requirements

• 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 • Preferred experience with Modio Health • 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 • Candidates must disclose any current or future need for employment-based immigration sponsorship (including, but not limited to, OPT, STEM OPT, or visa sponsorship) before an offer of employment is extended.

🏖️ 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!