Credentialing & Provider Enrollment Specialist @Medusind

[Hiring] Credentialing & Provider Enrollment Specialist @Medusind

Mar 26, 2025 - Medusind is hiring a remote Credentialing & Provider Enrollment Specialist. 💸 Salary: starting at $22/hourly. 📍Location: USA.

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Role Description

The Credentialing & Enrollment Specialist evaluates, analyzes, and coordinates all aspects of the credentialing and recredentialing processes of clinical providers and clinics with participating health insurance plans.

Enroll with health plans using accurate and detail orientation to complete health plan enrollment applications and submit enrollment to payors in a timely manner.
Deep understanding of health plans including CAQH, Medicare, Medicaid, Managed Care, and Commercial Plans.
Ensure CAQH are created and updated on a quarterly basis.
Enter, update, and maintain data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses.
Electronically prepare, track, and follow-up on appropriate verifications for efficient, high-volume processing of individual provider applications.
Monitor files to ensure completeness and accuracy; review all file documentation for compliance with quality standards and accreditation requirements.
Identify, analyze, and resolve extraordinary information or discrepancies that could adversely impact the ability to credential and enroll practitioners.
Communicate clearly with providers, their liaisons, medical staff leadership, and Administration to provide timely responses.
Maintain current and accurate records of provider and credentialing provider data, including initial and re-credentialing.

Qualifications

Bachelor’s degree in healthcare administration, Business, Finance, or a related field (preferred).
A minimum of 2 years of full-time experience in all facets of credentialing, including interactions with healthcare providers.
Experienced with Medicare, Medi-Cal, Managed Care, and Commercial insurances.
Strong knowledge of Federally qualified health centers (FQHCS) and Community Health Centers (CHCs).
Strong ability to collaborate with cross-functional teams.
High level of accuracy, with the ability to set and maintain priorities in a fast-paced environment.
Strong knowledge in the use of Microsoft Excel, Word, and Outlook.
Ability to adapt to changes in regulations, technologies, and industry trends.

Requirements

Detail-oriented with strong communication and collaboration skills.
Proficient in enrollment terminology.

Company Description

Medusind is a leading provider of revenue cycle management solutions to various specialties, including dental, behavioral health, anesthesia, pathology, emergency, surgery, and radiology.

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📍	Be aware of the location restriction for this remote position: USA
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Credentialing & Provider Enrollment Specialist @Medusind

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Salary 💸 starting at $22/hourly	Remote Location USA
Job Type full-time	Posted Mar 26, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Credentialing & Provider Enrollment Specialist @Medusind

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