Professional, Provider Enrollment (Multiple)

Professional - PES

 2-4 Years of experience in end-to-end process of Provider Enrollments/ Insurance Credentialing, Provider Contracting, and Re-Credentialing. Strong knowledge of US Credentialing Knowledge of provider credentialing and its direct impact on the practice’s revenue cycle. Adhere to organizational policies and procedure. Ability to prioritize and manage work queue. Knowledge of Microsoft Office (Word, Excel, Outlook). Excellent written and verbal communications. Essential Functions Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. Maintain internal provider grid to ensure all information is accurate and logins are available. Update each provider’s CAQH database file timely according to the schedule published by CMS. Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid etc. Maintains knowledge of current health plan and agency requirements for credentialing providers. Sets up and maintains provider information in online credentialing databases and system. Tracks license and certification expirations for all providers to ensure timely renewals. Ensures practice addresses are current with health plans, agencies, and other entities. Store the documents centrally on our secure document management systems. Periodic update of the document library for credentialing purpose. Maintain strict confidentiality in accordance with HIPAA regulations and company policy. Meeting daily/weekly and monthly targets set for an individual

Department: PES
Posted: 2026-10-23T07:48:07.167Z