Credentialing and Provider Enrollment Specialist

Remote Full-time
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the State of Florida) Status: Full Time (non-exempt) Shift: 8:00 AM to 4:30 PM (may vary) Days: Monday through Friday The Credentialing and Provider Enrollment Specialist is a full-time remote position. This team member must currently reside in Florida. Responsibilities Responsible for initiating and maintaining credentialing, managed care provider enrollment and hospital privileges for BayCare physicians and providers in accordance with NCQA, CMS, AHCA, State and Federal guidelines and regulations, as well as Department Policies, to ensure compliance with credentialing standards. Completes primary source verifications and assesses the provider's qualifications to ensure the providers meet BayCare's quality standards. Documents all verifications and data in the credentialing database to produce credentialing files that meet BayCare's quality standards within the time frames required by BayCare. Ensure providers remain compliant with all licensing and board requirements and will assist providers with renewals. Enrolls and maintains managed care enrollment by providing updates to the health/payor plans and will resolve errors and issues by coordinating with the plans, the CBO and the Managed Care contracting department. Why BayCare? Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve. BayCare offers a competitive total reward package including : Benefits (Health, Dental, Vision) Paid time off Tuition reimbursement 401k match and additional yearly contribution Yearly performance appraisals and team award bonus Community discounts and more AND the Chance to be part of an amazing team and a great place to work! Certifications and Licensures Preferred – CPCS (Credentialing) Education Required HS Diploma or Equivalent GED Preferred associate or bachelor’s degree preferred. Experience Required - 1 year Credentialing or 1-year Managed Care Equal Opportunity Employer Veterans/Disabled
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Paralegal/Personal Assistant

Remote Full-time

Chicago – Risk & Compliance – Lender Due Diligence (Financial Services) Senior Consultant

Remote Full-time

UX Writer (Contract | Part-time)

Remote Full-time

Engineer, Performance Engineering - Full-time

Remote Full-time

Experienced Cloud Engineer for American Express Careers Remote - MySmartPros Opportunity

Remote Full-time

[Remote] Principal Product Designer, Teamwork Collection

Remote Full-time

Project Accountant

Remote Full-time

Principal Data Scientist-Gen AI, Machine Learning (10042)

Remote Full-time

Experienced Data Analyst and Quality Control Standards Specialist – Remote Work Opportunity with Competitive Hourly Rate

Remote Full-time

**Experienced Full Stack Customer Service Representative – Remote E-commerce Support**

Remote Full-time
← Back to Home