Provider Contracting and Credentialing Specialist
The team is expanding and we currently have an exceptional opportunity available. The Credentialing/Contracting Specialist carries out the provider enrollment function as delegated by payor plans. This position serves as an integral member of the Provider Contracting Team and assists in developing the strategic direction and management of the day to day contracting and network management activities.
What you will do:
• Completes accurate and timely payor enrollments applications and coordinates workflow for applications in the queue, assigning work to the Credentialing Associate.
• Maintains the Provider Enrollment database and external databases. Secures documents for primary source verification.
• Produces and replies to general correspondence.
• Assures revalidation of providers with various payors in a timely manner. Interacts with representatives from health plans.
• Acts as a subject matter expert and internal consultant to various functions within HHC concerning provider enrollment.
• Coaches and mentors the Credentialing Associate.
• Provides guidance to providers on their enrollment, and on CAQH database updates.
• Processes standard provider contracts and works with internal departments to facilitate new and re- contracting efforts for all networks in a defined health service area.
• Associate Degree required, Bachelors Degree preferred
• 3 – 5 years experience in an administrative support capacity in healthcare at the advanced level required; 5 years experience working within the insurance agency, hospital or other healthcare setting with responsibilities related to credentialing or provider enrollment preferred
• Understanding of the credentialing and privileging process for health plans
• Computer Proficiency
• Microsoft Office to include Word, Excel, Power Point
• Ability to work with an application specific database
• Excellent interpersonal skills
• Customer service orientation
• Ability to work well within a team structure
• Attention to detail
• Ability to work with multiple projects and deadlines
• Strong analytical skills
• Knowledge of NCQA and delegated credentialing requirements
EQUAL OPPORTUNITY EMPLOYER
Atterro supports affirmative action and equal employment opportunity. Atterro will provide equal employment in employment practices to all associates and applicants for employment. Employment decisions shall be made without regard to any protected characteristic such as, but not limited to, race, color, religion, gender, age, disability, national origin, ancestry, gender identity, sexual orientation, marital status, status in regard to public assistance, disabled veterans, recently separated veterans, Armed Forces service medal veterans and other protected veterans, genetic information and other legally protected classes. Furthermore, Atterro is an E-Verify employer. Information provided on this application will not be used for any discriminatory purposes. Atterro complies with all applicable federal, state and local non-discrimination laws and regulations. Atterro will provide reasonable accommodations in the application or interviewing process. If you need a reasonable accommodation in the application or interviewing process, please contact us.
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