[Hiring] Provider Enrollment - Credentialing Specialist @Quadris Team LLC

Role Description

The experienced Provider Enrollment-Credentialing Specialist will perform facility and health plan credentialing for Physicians, Nurse Practitioners and PA's and work independently to coordinate, develop, monitor, and maintain the credentialing process.

• Assess current credentialing status of all employed and independently contracted providers
• Complete facility and payer applications as needed
• Work with leadership to ensure all provider credentialing is properly managed
• Review applications and verify education and training
• Maintain a database for new and existing providers
• Work with auditors as needed
• Responsible for all aspects of the credentialing, recredentialing and privileging processes for all medical providers
• Ensure providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities
• Maintain up-to-date data for each provider in credentialing databases and online systems
• Process initial credentialing and re-credentialing applications

Qualifications

• High School diploma or equivalent
• 2+ years previous experience in healthcare Payer Enrollment and Credentialing
• Proven experience credentialing MD's, DO's, NP's & PA's directly with Medicare, Medicaid, Commercial health plans and other private insurance companies
• Prefer working proficiency of CPT and ICD-10, and general knowledge of healthcare Revenue Cycle Management
• Must have professional level skills in MS products such as Excel, Word, PowerPoint

Requirements

• Maintains compliance with regulations and laws applicable to job
• Professional level communication expectations with video, phone and email
• Ability to effectively prioritize the work to meet deadlines and expectations
• Meets the quality and productivity measures as outlined by Quadris
• Brings positive energy to the work
• Uses critical thinking skills
• Being present at work and reducing distractions
• Being a self-starter
• Incredible attention to detail

Company Description

Quadris Team, LLC - A Revenue Cycle Management Group, is a 100% remote team supporting our Physician clients across the United States.