Your future role at a glance
Location: Remote
Department/Specialty: Credentialing and Payor Enrollment
Schedule: Full time | Days | Monday-Friday
Salary: $41,040.23-$55,531.47
#ACVS
#LI-Remote
How you'll make an impact in this role
Complete the day to day credentialing/re-credentialing for all providers. Ensure the provider file from ACVS meets managed care criteria.
Completes state specific credentialing verifications as necessary.
Send newly credentialed rosters to all delegated payers. Complete and submit CAQH applications to all non delegated payers. Run rosters for all delegated audits. Assist in audits related to credentialing/enrollment.Process provider data updates, changes and terms in MD Staff and submit to payers monthly. Follow up with payers to ensure new providers are loaded timely and correctly.
Produce required documentation to meet payer and NCQA guidelines.
Process provider data updates, changes and terms in MD Staff.
Stays abreast of regulatory, legal and legislative issues and requirements and communicates changes.
What minimum qualifications you'll need
Education:
High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
What additional requirements you'll need
2 or 3 years of delegated credentialing experience, strongly preferred.
2 or 3 years of health plan experience, strongly preferred.
Life at Ascension: Where purpose meets opportunity
Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
Equal employment opportunity employer
Equal employment opportunity employer
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.
Fraud prevention notice
Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.
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Benefits
Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community
Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.