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Balance Health

Nation's Premier Comprehensive Lower-Extremity Care Organization

Credentialing and Provider Enrollment Coordinator

GeneralGeneralFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

5 hours ago

Salary

0

Seniority

Senior

Associate Degree3 yrs expEnglish

Job Description

Credentialing and Provider Enrollment Coordinator

Balance Health

• Administer the provider credentialing process for practice providers and the provider enrollment process for insurance payers. • Ensure timely communication with practices and implementation teams to gather credentialing and enrollment information. • Process initial and re-credentialing applications and conduct primary source verification (CAQH, NPPES, etc.). • Credential, link, and revalidate providers and groups with commercial and government payers. • Maintain working knowledge of payer credentialing policies, forms, and compliance requirements. • Troubleshoot and resolve enrollment issues, including claim denials and unbilled problems. • Maintain accurate provider participation (PAR) lists and distribute updates to stakeholders. • Enter provider demographics and credentialing data into credentialing software. • Complete and track clearinghouse applications for EDI and ERA, and process EFT authorizations for payments. • Collaborate with internal teams to develop and refine enrollment policies and procedures. • Drive continuous improvement and contribute to special projects as needed.

Job Requirements

  • Associate or Bachelor’s degree in Healthcare Administration or related field preferred.
  • CPCS (Certified Provider Credentialing Specialist) preferred.
  • Minimum 3+ years of experience in healthcare payer enrollment and provider credentialing within a multi-specialty medical group.
  • Experience working with government agencies such as CMS and AHCA strongly preferred.

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