Government Credentialing & Enrollment Specialist - Part Time (Benefit Eligible)

Christie Clinic's department of Physician Outreach is seeking a part-time (20 hours/week) Government Credentialing & Enrollment Specialist at The Leadership Center in Champaign with varied hours of 2.5 days/week or 5 half days/week.

The Governmental Credentialing Specialist is responsible for preparing, submitting, and maintaining enrollment, credentialing and recredentialing documentation for Physicians, other healthcare Providers and Clinic facilities. The Governmental Credentialing Specialist will also cross train and collaborate with Commercial Credentialing Specialist to provide support and coverage, as needed.

JOB DUTIES: (This list may not include all of the duties assigned)

• Responsible for compiling and maintaining current and accurate data for all providers.
• Responsible for data entry and maintaining provider information in online credentialing databases and systems (CAQH, PECOS, NPPES).
• Responsible for completing provider and facilities initial and re-credentialing applications.
• Responsible for revalidation requests issues by government payers.
• Responsible for submitting completed credentialing application supporting documentation requests to payers.
• Responsible for monitoring application progress and following up with payers as needed until confirmation of application completion or “in-network” status is received.
• Cross train and provide support and coverage for Commercial Credentialing Specialist.
• Perform related work as required.

REQUIRED QUALIFICATIONS:

• High School Diploma or equivalent

PREFERRED QUALIFICATIONS:

• Working knowledge of credentialing accreditation regulations, policies, and procedures
• Prior Payer Provider Enrollment
• Healthcare experience, preferably in Billing and or insurance

CERTIFICATION/LICENSE:

• Certified Professional Credentialing Specialist (CPCS) certification (Preferred but not required)

TYPICAL WORKING CONDITIONS:

Demands include sitting, standing, walking, bending, stooping, stretching and lifting up to 20 pounds. Ability to work at a computer and keyboard for extended periods. Hearing within, or correctable to, normal range, vision correctable to 20/20 and manual dexterity for the operation of office equipment is required.

PAY AND BENEFITS:

The estimated pay range for this position is exclusive of fringe benefits and potential bonuses. Final offers are based on various factors, including skill set, experience, qualifications, and other job-related criteria.

We also offer a substantial benefits package, including: