Sentara
Credentialing Specialist I Provider Enrollment
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Job Description
- Req#: JR-83761
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from multiple states across the U.S.
- Comprehensive benefits package including medical, dental, and vision plans
- Support for education with tuition assistance up to $5,250/year
- Annual discretionary bonus based on eligibility criteria
- Unique benefits such as adoption and fertility reimbursement up to $10,000
What to Expect (Job Responsibilities):
- Ensure healthcare professionals and providers meet necessary qualifications and regulatory standards
- Gather and verify documents and information for credentialing purposes
- Coordinate with healthcare providers to maintain accurate credentialing files
- Comply with managed care provider credentialing and re-credentialing principles
- Maintain up-to-date knowledge of relevant regulations and procedures
What is Required (Qualifications):
- High School Diploma
- Minimum of 1 year of directly related experience in credentialing or managed care
- Thorough knowledge of managed care provider credentialing principles and regulations
- Experience with organizations such as a CVO, MCO, HMO, or Hospital-Based Credentialing (MSO)
- Certification as a Certified Provider Credentialing Specialist (CPCS) preferred
How to Stand Out (Preferred Qualifications):
- Experience with data analysis and revenue cycle management
- Familiarity with credentialing software and systems (e.g., Epic)
- Previous experience handling provider enrollment denials and appeals
- Knowledge of CAQH and MPI processes
- Excellent organizational and communication skills
#HealthcareServices #Credentialing #RemoteOpportunity #CareerGrowth #ComprehensiveBenefits
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