Payer Credentialing Specialist

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Payer Credentialing Specialist

Job Description

Payer Credentialing Specialist work under the supervision of the Managed Care and Denial Director, and is responsible for aspects of credentialing processes for Health System Payers.  Under the direction of the Director, processes and assists in providing Payers information regarding Health System locations and Providers.

Department: Managed Care and Denials

Hours: Part-Time, 24 hours a week required.

Shift: 3 days a week. 8:00am -4:30pm or 7:00-3:30pm

Location: Charleston, IL

Required: High School Diploma

Pay: Based on experience, starting at $19.61

Responsibilities

Enrolls/Maintains Health System Locations and Providers for Medicaid in IMPACT System., Enrolls/Maintains Health System Locations and Providers for Medicare in Provider Enrollment, Chain, & Ownership System (PECOS)., Enrolls/Maintains Health System Locations and Providers information on Insurance roster templates and submits monthly to Payers., Enrolls/Maintains Health System Locations and Providers National Provider Identifier (NPI) records through the CMS National Plan and Enumeration System (NPPES)., Enrolls/Maintains Health System Locations and Providers records in Council for Affordable Quality Healthcare (CAQH) system.

Requirements

High School (Required)

Compensation

Estimated Compensation Range

$19.61 - $30.40

Pay based on experience