Medical Staff Services Healthplan Credentialing Specialist

Job Summary

#HireNRHS

• Assists with the credentialing, re-credentialing of independent Nhealth Providers, NRHS employed Providers, and NRHS facilities.
• Contacts providers with Nhealth payers to complete the enrollment process and maintain the status logs of applications
• Supports the enrollment department by resolving problems, questions, and issues internally, as well as at the payer.
• Maintains facility TIN and Provider changes with payers
• Re-credentialing Nhealth Providers
• Process provider and facility terminations
• Following up on Provider APPS

• Associates degree required, Bachelor’s degree preferred.

• 3-5 years experience with provider credentialing.
• Knowledge of NCQA guidelines required.
• Medical Staff Services experience preferred.

• $18.80-$30.71/hr based on previous work experience
• Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement