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Leoforce

Credentialing & Enrollment Specialist

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What they do

An Enrollment Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. Assists eligible applicants with enrolling in a program.

$51,675 / year median in New Mexico

+9% projected growth

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Job Description

Credentialing & Enrollment Specialist Leoforce•3.0 Albuquerque, NM Job Details Permanent | Full-time $50,000•$60,000 a year 22 hours ago Qualifications Confidential information handling Microsoft Excel Microsoft Outlook Professional ethics Word embeddings
Full Job Description Experience:
Mid Level Salary:
$50,000•$60,000 per year Job Details•
Responsibilities:
Manage all aspects of the medical credentialing and enrollment process, including application, verification, and enrollment Ensure compliance with all relevant regulations and standards Maintain accurate and up-to-date records of credentialing and enrollment information Coordinate with various departments to ensure that all necessary documentation is received and processed in a timely manner Manage the renewal and re-credentialing process for all medical staff Conduct audits to ensure that all credentialing and enrollment activities are in compliance with regulatory standards Develop and implement policies and procedures related to credentialing and enrollment Collaborate with the finance team to ensure accurate billing and reimbursement processes Act as a liaison between our organization and external entities, such as insurance companies and regulatory bodies Stay up-to-date with changes in credentialing and enrollment standards and regulations, and implement necessary changes to ensure compliance
Qualifications:
Minimum of 3 years of experience in medical credentialing and enrollment, with a focus on compliance Prior experience in the nonprofit sector is strongly preferred Comprehensive knowledge of credentialing and enrollment processes and standards Strong understanding of compliance regulations Excellent organizational skills with the ability to manage multiple tasks simultaneously Strong attention to detail and accuracy Excellent written and verbal communication skills Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) Ability to work independently and as part of a team Strong problem-solving skills and the ability to think critically High level of integrity and professionalism Ability to handle sensitive information with discretion and confidentiality.
A bit about us:
•We are seeking a dynamic and detail-oriented Credentialing & Enrollment Specialist to join our team. This role is ideal for a seasoned professional with a strong background in compliance, medical credentialing and enrollment, and the nonprofit industry. As a vital part of our team, you will play a crucial role in ensuring that our organization meets all necessary compliance and credentialing standards. You will be responsible for managing the entire credentialing process, from application to verification and enrollment. This is a permanent, full-time position with excellent benefits and opportunities for professional growth. Why join us?•One of the things that makes this opportunity unique is the chance to join a mission-driven nonprofit where your work has a direct impact on the community. In addition to competitive benefits and excellent work-life balance. #accounting-finance #compliance #credentialing #provider-enrollment #nonprofit-industry #medical-credentialing-and-enrollment #tier2