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The analyst manages enterprise credentialing and enrollment processes to ensure compliance with regulatory and payer requirements. They collaborate with internal and external stakeholders to streamline workflows and maintain accurate provider data records.
Responsible for managing enterprise credentialing and enrollment processes and projects, ensuring compliance with state, federal, regulatory, and payer requirements. Collaborates with providers, internal teams, and external stakeholders to streamline workflows and maintain accurate provider data records. Ensures timely onboarding of professionals for optimal revenue and patient access. Serves as credentialing and enrollment subject matter expert, handling system projects and initiatives in support of organization growth and goals.
Must have a Bachelor’s degree in Business, Healthcare or related field; or the equivalent of 8 years of transferrable skills and experience. Certification by National Association Medical Staff Services as a Certified Provider Credentialing Specialist (CPCS) or Provider Enrollment Specialist (PESC) is preferred but not required. Minimum 3 years serving in a role with project management, business or health care related experience, preferably medical staff services, managed care or provider enrollment.
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