Provider Enrollment Specialist

A company is looking for a Provider Enrollment Specialist to manage provider enrollment activities and maintain credentialing and verification needs.

Key Responsibilities

Collaborates with Medical Staff Services and Contracting to ensure accurate credentialing and group contracts

Initiates provider enrollment with federal and managed care plans to establish billing privileges

Maintains and updates provider data in credentialing databases and manages enrollment workflows

Required Qualifications

High School Diploma or GED required

At least 1 year of experience in provider enrollment, credentialing, billing, or finance in healthcare

NAMSS certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred

Knowledge of accreditation standards and legal requirements related to provider enrollment

Proficiency in credentialing software and Microsoft Office products preferred