Sr. Credentialing & Enrollment Specialist
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Job Location:
North Haven, CT - USA
Monthly Salary:
Not Disclosed
Posted on:
8 hours ago
Vacancies:
1 Vacancy
Job Summary
Location: Hybrid 2 days a week in our North Haven CT Office.
The Senior Credentialing & Enrollment Specialist is responsible for all aspects of the credentialing re-credentialing and privileging processes for all launching all providers in Privias high performance medical group.
- Assures compliance with all health plan requirements as related to the provider certification and credentialing.
- Works with leadership team in reviewing and streamlines processes and workflows for the on-boarding department using automation where appropriate
- Oversees special projects requiring knowledge of delegated and non-delegated health plan requirements
- Works with leadership team to develop a more streamlined process for distribution of
- Credentialing Packets and is responsible for distribution of same.
- Leads ¼ of the cred committee meetings and maintains minutes for each.
- Responsible for training and onboarding of all new employees responsible for credentialing for Privia.
- Assigns files to credentialing staff and ensures equal distribution of inventory across all markets.
- Interacts with varied levels of management physician office staff and physicians effectively to
- accomplish credentialing and various elements of implementation and launch
- Maintain up-to-date data for each provider in credentialing databases and online systems;
- ensure timely renewal of licenses and addition the Credentialing and
- enrollment specialist is responsible for all audits to ensure that delegated credentialing entities are compliant.
- Will be responsible for completing 25 files per month based on time in production.
- Maintains confidentiality of provider information
- Coordinate and prepare reports
- Record and track credentialing statistics
- Other duties as assigned
Qualifications :
- 3 years experience in managed care credentialing billing and/or Medical Staff service setting
- Demonstrated skills in problem solving and analysis and resolution
- Advanced Microsoft Excel skills
- Must be able to function independently possess demonstrated flexibility in multiple project management
- Must comply with HIPAA rules and regulations
- An individual with the ability to communicate appropriately and effectively with practitioners internal stakeholders and providers; including sensitive and confidential information
- High level of attention to detail with exceptional organizational skills
- Exercise independent judgment in interpreting guidelines of applicable regulatory bodies.
The salary range for this role is $60000 to $68000 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 15%. The base pay offered will be determined based on relevant factors such as experience education and geographic location.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
No
Employment Type :
Full-time
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
Privia Health is a national physician platform transforming the healthcare delivery experience. We provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and popul ... View more
