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Credentialing Specialist I Provider Enrollment: JR-83761

Sentara Healthcare • Full-time • Remote (United States) • 3d ago

Department and Name: Provider Enrollment- Consolidated Hospital Support

Sentara Facility: Sentara Patient Accounting

Physical Location: Norfolk, VA

Location Type: Remote

Employment Status: Regular-Full time

Shift: First (Days)

This is a Full-time, 40 hours per week Day shift position Mon-Fri between the hours of 7:00am-5:00pm.

Responsible for ensuring that healthcare professionals and providers meet the necessary qualifications and comply with all regulatory and accreditation standards. This role involves gathering and verifying a variety of documents and information, coordinating with healthcare providers, and maintaining accurate and up-to-date credentialing files.

Education

High School Diploma

Certification/Licensure

CPCS – Certified Provider Credentialing Specialist (Preferred)

Experience

Requires thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 1 year of directly related experience. Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).

Keywords: Talroo-Health Plan, Monster, LinkedIn, Credential Stream, excel, data analysis, accounts receivable, Epic, revenue cycle, billing, provider not enrolled denials, appeals, onboarding, MPI, CAQH, CVO, MCO, HMO or Hospital Based Credentialing (MSO).