- Cincinnati, Ohio, United States
- On-site
- Full-time · Mid
- 4–8 years
Independently manages credentialing and enrollment applications from receipt through completion for Medical and Allied Health staff across multiple payors, including complex enrollment maintenance and Medicare/Med Medicaid updates.
Responsibilities
- Independently manages credentialing and enrollment applications from receipt through completion for Medical and Allied Health staff across multiple payors
- Collects, validates, and analyzes provider information and supporting documentation to determine completeness and compliance with established requirements
- Completes paper and electronic applications, CAQH and Cactus updates, spreadsheets, and payor portal submissions with minimal supervision
- Monitors application status, responds to requests for additional information, resolves routine discrepancies, and escalates high-risk or nonstandard barriers
- Coordinates activity across providers, internal departments, payors, and external entities to meet enrollment and maintenance deadlines
Requirements
- High School diploma or GED
- Nice to have: CPCS (Certified Provider Credentialing Specialist)