Credentialing and Enrollment Manager

Description

Neighborhood Family Practice is a Federally Qualified Health Center dedicated to providing comprehensive, high-quality, affordable healthcare to diverse, underserved communities. Our mission is to deliver equitable and accessible care, empowering everyone on their path to better health.

Our Benefits include:

• National Health Service Corps Scholarships and Loan Repayment
• CME, CEU Reimbursement and Tuition Assistance Programs
• Comprehensive Benefits – Medical, Dental, Vision, and Life Insurance within first 30 days of Full-Time Employment
• Paid Holidays off
• Paid Time Off
• 403(b) retirement plan with company match
• And more!

NFP offers an opportunity to provide meaningful care to underserved and marginalized patients in a Community Health setting, contributing to personal and professional satisfaction.

Essential Duties:

• Responsible for provider credentialing applications, initial and re-credentialing, with payers, including CAQH, Medicare/Medicaid, Commercial Payers. Monitor and follow-up as needed to ensure timely processing of credentialing requests.

• Remain up to date on federal, state, local, HRSA, or other regulatory bodies standards to ensure compliance at all times. Maintain knowing of current health plan and agency requirements for enrolling providers.

• Collaborate with Human Resources during provider credentialing and re-credentialing to collect, track, and exchange necessary information and documentation for timely privileging.

• Maintain provider information in online credentialing databases and systems to assure all information is accurate and updated. Assist in set up of providers in databases as needed.

• Maintain credentialing reports, including a log of pending and completed tasks, auditing health plan directories, making recommendations for improved efficiency in processes.

• Other duties as assigned.

NFP is committed to equal employment opportunities for all individuals and does not discriminate on the basis of race, color, religion, national origin, sex, gender or gender identity, age, or any other basis protected by Federal, State, or Local Law. Reasonable accommodations will be made to allow individuals with disabilities to complete the essential duties of the position.

Qualifications

• Associate’s Degree or higher strongly preferred
• Certified Provider Credentialing Specialist (CPCS) strongly preferred.
• 3+ years in Privileging, Credentialing, or related role required.
• Experience with CAQH and HRSA strongly preferred