Credentialing Enrollment Specialist

• Compile and maintain current and accurate data for provider credentialing records
• Maintain provider licenses, certifications, health records and CMEs; track expirations for timely renewals
• Complete provider initial and reappointment applications
• Monitor applications and follow up to support completion
• Review credentialing applications for completeness and accuracy
• Communicate with providers to collect and maintain required information
• Perform verifications of credentialing records
• Assist hospitals and health plans with information needed for provider credentialing files
• Respond to telephone and email inquiries in a timely manner
• Ensure security and confidentiality of credentialing records
• Work with the credentialing manager to identify and resolve credentialing issues
• Perform other related duties as assigned

• Reside in Minnesota or Wisconsin
• High school diploma or equivalent
• Associate’s degree preferred
• Certified Provider Credentialing Specialist (CPCS) preferred
• 2 years of experience in credentialing or similar medical business office role preferred
• Ability to work independently with minimal supervision
• Proficient use of Microsoft Office applications (Outlook, Word, Excel) and internet resources
• Strong computer and data management skills
• Understanding of the credentialing process, best practices and applicable regulations
• Ability to organize work and priorities to meet credentialing and recredentialing deadlines
• Excellent verbal and written communication skills
• Excellent attention to detail

Demonstrates expertise in provider credentialing processes, including data management, application review, and compliance with regulations. Proficient in maintaining accurate records and ensuring timely renewals while communicating effectively with providers.

• Provider Credentialing
• Data Management
• Microsoft Office Proficiency
• Attention to Detail
• Communication Skills

• Credentialing Process
• Application Review
• Record Verification
• Data Compilation
• Health Record Management

• Organizational Skills
• Independence
• Problem-Solving

• Certified Provider Credentialing Specialist (CPCS)

• Provider Licenses
• CME Tracking
• Credentialing Regulations
• Medical Business Office

• Microsoft Outlook
• Microsoft Word
• Microsoft Excel
• Internet Resources