Job Description
City/State Norfolk, VA
Work Shift First (Days)
Overview: Sentara Health is hiring a Payor Enrollment Credentialing Specialist I for the Provider Credentialing Department. This is a
Full-time, 40 hours per week Day shift position Mon-Fri between the hours of 7:00am-5:00pm.
The position is located in VA or could be remote - work from home is available only in these states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming
Responsible for ensuring that healthcare professionals and providers meet the necessary qualifications and comply with all regulatory and accreditation standards. This role involves gathering and verifying a variety of documents and information, coordinating with healthcare providers, and maintaining accurate and up-to-date credentialing files.
Education Certification/Licensure - CPCS - Certified Provider Credentialing Specialist (Preferred)
Experience - Requires thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 1 year of directly related experience. Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).
Keywords: Talroo-Health Plan, Monster, LinkedIn, Credential Stream, excel, data analysis, accounts receivable, Epic, revenue cycle, billing, provider not enrolled denials, appeals, onboarding, MPI, CAQH, CVO, MCO, HMO or Hospital Based Credentialing (MSO).
Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Job Tags
Full time, Temporary work, Work experience placement, Work from home, Shift work, Day shift,