Provider Enrollment Specialist

Job Summary

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