CardioOne is hiring a
Credentialing and Enrollment Specialist

Summary

Join CardioOne in our mission to positively impact US cardiology as a Credentialing and Enrollment Specialist.

Requirements

• Associate’s degree in healthcare administration, business, or a related field
• Minimum of 2 years of experience in provider credentialing and payer enrollment
• Familiarity with healthcare regulations, credentialing standards, and insurance processes
• Cardiology practice experience preferred

Responsibilities

• Document and verify the credentials of healthcare providers, including licenses, certifications, education, and work history
• Submit hospital affiliation applications and collaborate with onboarding providers and practitioners
• Coordinate credentialing files with leadership and credentials committees
• Assure compliance with credentialing, privileging, facility, accreditation, and health plan regulatory requirements
• Work expirables and maintain accurate databases, online systems, and documentation related to provider credentialing and enrollment
• Facilitate the enrollment process for providers with insurance companies, health plans, and government programs
• Prepare and submit enrollment applications and documents to insurance companies, health plans, and regulatory bodies
• Track and manage the status of applications and resolve issues or discrepancies
• Ensure timely re-credentialing and re-enrollment
• Prepare and submit weekly and monthly reports on set cadence
• Manage communications with insurance companies and other stakeholders. Address and resolve any payer issues or concerns
• Perform payer contract verification, request payer contract agreements, and ensure providers are enrolled with health plans within designated timeframes
• Research and document clinical guidelines, fee schedules, and payer contract changes
• Ensure compliance with national, state, and local regulatory requirements
• Attend meetings, trainings, and reviews as necessary
• Additional duties as assigned

Benefits

Full-time base salary range of $47,000 to $60,000 per year dependent on years of experience and includes medical, dental, vision, and a 401K match