Credentialing & Enrollment Coordinator

This is a fully remote position, open to applicants in Alabama, +32 more states.

📋 Description

• Process and submit complete, accurate, and timely applications and rosters to relevant stakeholders.

• Interpret and help implement the standards set by the National Committee for Quality Assurance (NCQA).

• Maintain and audit the integrity of credentialing software and data.

• Update the credentialing database as necessary.

• Handle requests and prepare correspondence to health plans through monthly communications.

• Act as the primary contact for practices and health plans regarding enrollment issues and directory listings.

• Conduct quarterly, semi-annual, and annual audits for health plans.

• Ensure current licensure, certifications, malpractice insurance, and other relevant regulatory items are maintained at the time of appointment and continuously thereafter.

• Guarantee the timeliness, accuracy, and integrity of the credentialing database system while ensuring compliance with regulatory agencies.

⛳️ Requirements

• High School Diploma or GED is required.

• A Bachelor's Degree is preferred.

• Certification from the National Association Medical Staff Services or as a Certified Provider Credentialing Specialist is preferred.

• Prior experience as a Credentialing Coordinator or in Provider Enrollment is preferred.

• Familiarity with NCQA standards and guidelines is essential.

• Proficient with technology.

• Self-motivated individual.

• Strong attention to detail.

• Excellent critical thinking abilities.

• Remote work is approved only for residents of AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

🏝️ Benefits

• Eligible for benefits.

• A comprehensive suite of Total Rewards.

• Competitive salary.

• Premium pay options, including shift and on-call pay, based on eligibility.

• Incentive pay for select roles.

• Possibility of annual salary increases based on performance.

• Paid Time Off programs.

• Medical, dental, and vision coverage.

• Life insurance coverage.

• Short- and Long-Term Disability benefits.

• Flexible Spending Accounts for eligible healthcare and dependent care expenses.

• Adoption assistance programs.

• Paid parental leave.

• Defined contribution retirement plans with employer matching.

• Additional financial wellness programs.

• Educational Assistance Program.