Credentialing & Enrollment Coordinator, Provider Enrollment

Position: Credentialing & Enrollment Coordinator

Department: Provider Enrollment

Schedule: Full Time, 40 hours, Days

POSITION SUMMARY:

Under the supervision of the Director, Medical Affairs & Credentialing and Manager of Provider Enrollment, is responsible for the timely credentialing for all Medical-Dental Staff and enrollment of all new and existing practitioners with third party payors. Requests and obtains provider data. Maintains provider information in existing computer software systems.

Requires an individual with strong organizational skills, detail oriented with an ability to work in varied and busy atmosphere and an individual who can independently organize and prioritize the workload to support the goals of the Boston Medical Center Health System. Maturity, discretion and an ability to maintain confidentiality are of utmost importance.

JOB REQUIREMENTS

EDUCATION:

• Associates degree or equivalent experience. Bachelor's degree preferred.

EXPERIENCE:

• Requires 1 - 3 years experience in a healthcare system, group practice, Medical Staff Office, credentials verification organization or health plan.

KNOWLEDGE AND SKILLS:

• Knowledge of provider credentialing and/or enrollment required.
• Ability to work well with all levels of personnel to establish and maintain harmonious working relationships with providers, chiefs of service, department directors and administrative staff and outside agencies.
• Strong communication, time management and organizational skills required to keep a very large and complex system running efficiently. Ability to prioritize duties and meet deadlines.
• Work requires ability to consolidate information from various sources. Ability to identify problems in the credentialing and enrollment process and strong problem solving skills needed to resolve any problem as they arise.
• Proficiency with Microsoft Office applications (i.e. MS Word, Excel, Access, PowerPoint, Outlook) and web browsers. Experience with CAQH system and third party insurance Websites
• Promotes and maintains a professional demeanor both personally and professionally
• Able to function independently and perform routine department procedures without supervision.
• Must have proven ability to maintain sensitive and confidential information.

Equal Opportunity Employer/Disabled/Veterans