Provider Enrollment & Credentialing Specialist - Two Chicks With A Side Hustle

Employer: Rethink Behavioral Health

Our team specializes in Revenue Cycle Management, as well as Enrollment and Credentialing Services. We are looking for professionals that are customer-focused and enjoy a fast-paced environment. Remote opportunities are available only in the following states: CA, CO, FL, GA, IL, IN, MO, NE, NY, NC, PA & TX

Under the direction of the Enrollment Manager, the Enrollment Specialist is responsible for the following:

Essential Duties: (but not limited to)

Ensure strict HIPAA-compliant confidentiality with all client-related data Manage and review enrollment onboarding documentation
Complete new client enrollment verifications
Set up and manage providers in credentialing tracking software

Verify NPI’s and other customer enrollment information
Complete, submit, and follow up on credentialing requests and applications on a regular schedule that will result in faster turnaround times.
Communicate payor enrollment and credentialing statuses as needed with Rethink team members

Collaborate with Rethink Billing Team members to resolve claims denials that are specific to credentialing
Document and communicate updated payor credentialing requirements externally and internally
Escalate and communicate any at-risk customer accounts to Supervisor

Keep customers informed and up to date regarding provider renewals, expirations, and application processes
Monitor provider credentials and licenses to ensure timely renewals Maintain and keep up to date on all payor enrollment requirements
Serve as enrollment and credentialing subject matter resource internally and externally

Attend client meetings as needed and/or required

Required Qualifications

Previous customer service and/or office experience Minimum 1 year previous credentialing experience Strong verbal and interpersonal skills
HS Diploma or Equivalent