Sentara Healthcare
Credentialing Specialist I Provider Enrollment
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Job Description
- Req#: JR-83761
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Medical, Dental, and Vision plans provided
- Adoption, Fertility, and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave, along with Paid Parental & Family Caregiver Leave
- 401k/403B with Employer Match and Tuition Assistance of $5,250/year
- Opportunity to earn an annual discretionary bonus based on eligibility criteria
- Flexible remote work option available in multiple states
What to Expect (Job Responsibilities):
- Ensure healthcare professionals and providers meet necessary qualifications and comply with regulatory and accreditation standards
- Gather and verify various documents and information required for credentialing
- Coordinate with healthcare providers to maintain accurate and up-to-date credentialing files
- Manage the credentialing/re-credentialing process effectively
- Utilize knowledge of managed care provider credentialing principles and regulations
What is Required (Qualifications):
- High School Diploma or equivalent
- Minimum of 1 year of directly related experience in managed care provider credentialing/re-credentialing
- Thorough knowledge of credentialing principles, methods, regulations, and procedures
- Experience with organizations such as CVO, MCO, HMO, or Hospital Based Credentialing (MSO)
- Certification as a Certified Provider Credentialing Specialist (CPCS) is preferred
How to Stand Out (Preferred Qualifications):
- Familiarity with data analysis tools such as Excel
- Experience using credentialing software like Epic
- Knowledge of revenue cycle processes and accounts receivable
- Background in handling provider not enrolled denials and appeals
- Interest in professional development and completion of CEUs
#HealthcareServices #Credentialing #RemoteWork #CareerGrowth #EmployeeBenefits #DiversityAndInclusion
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.
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