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Caris Life Sciences

Senior Enrollment Specialist - Credentialing

RemoteUnited States onlyArchived
Published
Experience
Senior
Employment
Full-time
Company size
Enterprise
$68k–$82k/yr
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Open to US only. Set where you work from to check your eligibility.

No BS summary

Senior credentialing specialist for US-based payer enrollment. 4–6 years credentialing experience required, knowledge of Medicaid/Medicare and NCQA/state/federal standards. Remote (US) role; must be able to work with payer databases and MS Office.

Core skills

payer enrollmentcredentialing databases

Required skills

Microsoft ExcelMicrosoft WordAdobedatabase querying (preferred)

Optional skills

CPCS (Certified Provider Credentialing Specialist)bachelor's degreedatabase management including querying and reporting

What you'll do

  • Oversee, monitor, and maintain processes for initial and revalidation of payer enrollment applications.
  • Ensure compliance with payer enrollment requirements and regulations.
  • Submit applications ahead of deadlines and follow up with payers through completion.
  • Research and document enrollment processes including initial enrollment, revalidation, and demographic changes.
  • Regularly update and manage data in credentialing database, spreadsheets, and folders while maintaining data integrity.
  • Assure compliance with payer requirements related to provider enrollment and monitor activities for compliance with procedures and regulations.
  • Participate in development and implementation of credentialing processes and provide input on process improvement.
  • Serve as primary contact for payer inquiries and issue resolution related to enrollment and credentialing.
  • Assist in training colleagues on internal enrollment policies and procedures and provide guidance on navigating payer agency requirements.
  • Perform other duties as assigned.

What they require

  • High school diploma or GED required.
  • Four to six years of experience in a credentialing office or equivalent related environments.
  • Knowledge of health plan and governmental payer credentialing process and requirements, such as NCQA/state/federal standards, Medicaid, and Medicare.
  • Proficient communication abilities, both orally and in writing, and strong interpersonal skills.
  • High attention to detail.
  • Outstanding organizational and time management skills.
  • Ability to work autonomously while contributing to a collaborative team environment.
  • Ability to maintain confidentiality.
  • Proficient in Database, MS Excel, Word, Adobe and other software systems.
  • Team player with multi-tasking capability and strong customer service orientation.

Benefits

  • Highly competitive and inclusive medical, dental and vision coverage options
  • Health Savings Account for medical expenses and dependent care expenses
  • Flexible Spending Account to pay for certain out-of-pocket expenses
  • Paid time off, including: vacation, sick time and holidays
  • 401k match and Financial Planning tools
  • LTD and STD insurance coverages, as well as voluntary benefit options
  • Employee Assistance Program
  • Pet Insurance
  • Legal Assistance
  • Tuition Assistance

Backed by cutting-edge molecular science and AI; precision medicine and tumor profiling solutions; mission-driven healthcare/diagnostics company.

🇺🇸 United StatesHealthcareEnterprisecarislifesciences.com/
$68k–$82k/yr