Credentialing & Enrollment Specialist – Payer Enrollment

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Financial ServicesIndustries

Requirements

Candidates must have 3-5+ years of experience in payer enrollments, preferably for multi-disciplinary provider groups, and extensive experience with Medicaid in a multi-state organization. Telehealth experience is strongly preferred, along with a working knowledge of clinical operations and procedures. The role requires the ability to use independent judgment, manage confidential information with discretion, and demonstrate advanced working knowledge of Verifiable, Athena, and Microsoft Office suite, including advanced skills in computerized spreadsheeting and database management.

Responsibilities

The Credentialing & Enrollment Specialist will manage payer enrollments for multi-disciplinary providers with state Medicaid and payer partners, ensuring application completeness and accuracy. Responsibilities include completing applications, performing follow-up, conducting monthly roster reconciliations, and resolving discrepancies that could impact provider enrollments. The specialist will also identify and convey roadblocks to enrollment to senior management and maintain professional growth by staying abreast of healthcare industry regulations and legislation. Miscellaneous job-related duties may also be assigned.

Skills

Payer Enrollment

Credentialing

Medicaid Enrollment

Provider Enrollment

Roster Reconciliation

Data Accuracy

Communication

Problem-Solving

Regulatory Compliance

Imagine Pediatrics

24/7 virtual pediatric care and support

About Imagine Pediatrics

Imagine Pediatrics offers 24/7 virtual pediatric care customized for children with medical complexity, providing unlimited access to care via messaging, phone call, or video visit, and coordinating with the child's existing care team. Their multidisciplinary team of pediatricians, nurses, social workers, and care coordinators delivers high-quality, virtual-first care and support, with services currently available in Texas and Florida.

220 Athens Way #240, Nashville, TN 37228, USAHeadquarters

2022Year Founded

$5MTotal Funding

SEEDCompany Stage

51-200Employees