Provider Enrollment and Credentialing Specialist

Overview

Join our team as a Provider Enrollment and Credentialing Specialist, where your expertise will be pivotal in ensuring seamless provider onboarding and credentialing processes for Applied Behavior Analysis provider in WA State. In this role, you will manage the enrollment of healthcare providers with various managed care organizations and government programs, ensuring compliance with industry standards and regulations. Your proactive approach will help maintain accurate provider records, facilitate timely credentialing, and support our commitment to delivering exceptional healthcare services. This is an exciting opportunity to contribute to a mission-driven organization that values precision, efficiency, and professional growth.

Responsibilities

• Coordinate and complete provider enrollment applications with managed care Medicaid, MCOs and Commercial Carriers. Preference given to Washington State residents.
• Register licensed provider with WA Medicaid and complete provider interest forms for commercial carrier. Register certified providers with WA Medicaid and roster with Medicaid MCOs.
• Maintain up-to-date provider records in compliance with regulatory requirements and organizational policies.
• Collaborate with medical offices to gather necessary documentation and resolve enrollment issues promptly.
• Track application statuses, follow up on pending submissions, and ensure timely credentialing processes.
• Review and interpret medical terminology related to provider credentials and enrollment documentation for accuracy.

Skills

• Strong understanding of managed care systems and provider enrollment procedures.
• 2-3 years or previous credentialing experience.
• Proficiency in medical terminology to accurately interpret provider credentials and documentation.
• Excellent organizational skills with the ability to manage multiple applications simultaneously under tight deadlines.
• Effective communication skills for liaising with providers, insurance companies, and internal teams.
• Attention to detail to ensure accuracy in all aspects of credentialing and enrollment activities. This role offers an engaging environment where your skills directly impact the efficiency of healthcare delivery while supporting your professional development within a collaborative team dedicated to excellence in healthcare administration. Preference given to Washington State residents.

Pay: $21.00 - $23.00 per hour Work Location: Remote