Enrollment and Credentialing Specialist - Great Location - Boston Massachusetts

Location: Boston, Massachusetts
Posted On: 01/18/2025

This Enrollment And Credentialing Specialist Position Features:

? Great Location

? Professional Work Environment

? Growth Opportunities

? Great Pay



Immediate need for enrollment and credentialing specialist seeking great location, professional work environment and growth opportunities. Credentialing experience, medical terminology and enrollment experience will be keys to success in this stable organization. Will be responsible for ?Performs credentialing and re-validation activities for prospective and current MassHealth providers according to established guidelines. Duties include; reviewing provider applications, applying policy and criteria based on provide type, performing source verifications and processing provider files. Ensures provider compliance in regards to licensing and sanction information with all accrediting organizations and regulatory agencies including;

Maintain provider updates as requested, verifying data and entering information. Completes all documentation and data entry in a timely and accurate fashion.

?Follows regulation time frames and procedural guidelines for processing applications, updates and disenrollment activities according to company and contract standards.

?Responds to all provider enrollment related inquiries and requests in a timely and thorough fashion. Maintains professional interactions with providers, persistently following up on missing enrollment information and required documentation to complete file.

?Communicates to providers any regulations and certification changes that affect file maintenance or membership, obtaining necessary documentation from providers for processing.

Communicates provider problems, inquiries or issues that cannot be resolved independently through the appropriate channels for resolution.





Great benefits. Apply for this great position as a enrollment and credentialing specialist today! We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status. More...

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