The Credentialing Specialist is responsible for preparing and submitting provider payer enrollment applications and supporting documentation for the purpose of enrolling individual practitioners and provider groups with appropriate commercial and governmental payers. He/She updates and maintains the payer enrollment database and assists the Director in identifying the impact of pending payer enrollments to AR outcomes. Works closely with the Physician onboarding department to communicate with providers the information necessary to complete payer enrollments. Maintains an updated and accurate inventory of all providers status with payers and takes necessary steps to maintain current and accurate enrollments.
The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters.
Requirements for Credentialing Specialist: