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Provider Enrollment / Credentialing Specialist

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Company Name:  EnduraCare Acute Care Services
Job #:
 ECC0007840-A
Job Type:  Full Time
Job Category:  Accounting/Finance
Location:  Franklin, TN
Job Description:  

Position: Provider Enrollment / Credentialing Specialist
FTE: Full-time
Location: Franklin, TN

Experience Required

We are seeking someone who possess extensive knowledge and has experience in all aspects of the credentialing, re-credentialing and privileging processes. This position is responsible for ensuring providers are credentialed, appointed, and privileged with health plans. 

We are seeking someone who possess knowledge and has experience in all aspects of the credentialing, re-credentialing and privileging processes. This position is responsible for ensuring providers are credentialed, appointed, and privileged with health plans. Must have "payor enrollment" experience.
**Familiarity with CAQH and PECOS is a must.


EnduraCare fosters a TEAM environment with a strong culture built on integrity and work ethic.


ABOUT US
EnduraCare Acute Care Services, founded in 1981, is the nation''s largest privately-held provider of therapy program management for hospitals and free-standing outpatient clinics.  We are headquartered in Franklin, Tennessee and operating in more than 14 states.  We deliver labor productivity, revenue growth, staffing solutions, educational resources, and rehab expertise to ensure optimal performance.  We are experts at and understand the complex reimbursement structures across all venues.   We do one thing, and we do it well! To learn more, visit our website: www.enduracareac.com

ABOUT THIS ROLE
To be successful in this role, the candidate must be a ''people person'', have a jovial personality, be extremely flexible, innovative and team oriented; This position requires strict adherence to confidentiality and the maintenance of confidential documents / information.

Essential Duties and Responsibilities
The position is responsible for all aspects of the credentialing, re-credentialing and privileging processes for Rehabilitation Therapists who provide patient care. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.

  • Compiles and maintains current and accurate data for all providers.
  • Completes provider credentialing and re-credentialing applications; monitors applications
  • and follows-up as needed.
  • Maintains copies of current state licenses, DEA certificates, malpractice coverage and
  • any other required credentialing documents for all providers.
  • Maintains corporate provider contract files.
  • Maintains knowledge of current health plan and agency requirements for credentialing providers.
  • Sets up and maintains provider information in online credentialing databases and system.
  • Tracks license and certification expirations for all providers to ensure timely renewals.
  • Ensures practice addresses are current with health plans, agencies and other entities.
  • Tracks license, DEA and professional liability expirations for appointed Health providers.
  • Audits health plan directories for current and accurate provider information.
  • Submit closed files for audit/final review and secure missing items as identified by audit/final review
  • Monitor collection of all information received; follow up on missing items and/or incomplete forms

Required Skills:

  • Knowledge and understanding of the Outpatient Rehab Therapy credentialing process.
  • Ability to organize and prioritize work and manage multiple priorities.
  • Excellent verbal and written communication skills including, letters, memos and emails.
  • Excellent attention to detail.
  • Ability to research and analyze data.
  • Ability to work independently with minimal supervision.
  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
  • Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.
  • 1 year experience in healthcare credentialing preferred
  • Associate degree or an equivalent combination of education and experience required
  • Bachelor degree preferred
  • Experience with credentialing accreditation by Joint Commission or National Committee for Quality Assurance preferred


Submit Resume to: 

Chanta Courtney
Director of Recruiting
ccourtney@enduracareac.com
www.enduracareac.com
Office: 615-538-4600

LinkedIN: https://www.linkedin.com/in/chantacourtney

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