Provider Enrollment & Credentialing Specialist

US Heart and Vascular is in need of a Remote Provider Enrollment \& Credentialing Specialist to join our team **Position Summary** Be the first point of contact to staff; resolve enrollment \& credentialing issues by answering questions, making recommendations for resolution and escalation, checking enrollment status, verifying payer enrollment requirements and system implementation, appropriately follow\-up on Provider Issue Forms; facilitates group and individual enrollment with commercial and government payers.**Responsibilities:*** Resolves issues and concerns by correctly answering questions from staff and providing appropriate follow\-up on issues, escalating to Team Manager, when appropriate * Provides the team with coaching, training, and auditing on assigned tasks. Partner with Team Manager to evaluate team’s performance to improve overall production and facilitate continuous improvement. * Assists Team Manager in monitoring inventory and production and facilitates the escalation process as needed. * Become proficient in discussions with payors to facilitate closure of any identified issues. * Research and review individual Provider Issue Forms for appropriate follow\-up and resolution. * Maintain Matrices \- payer enrollment, matrix, SOPs, new site sheets, email templates, welcome letters, etc. * Create and distribute reports containing provider credentialing and enrollment data for various departments within the organization. * Research new state enrollment requirements for group and individual provider enrollment. * Assists Contract Implementation staff with accurately documenting enrollment and billing requirements for payer contracts. * Maintain and complete new entries in Veritystream. * Facilitate completion and submission of payer enrollment applications for government and commercial payers. * Monitor application status process to identify emerging issues and communicate them to Team Manager. * Monitor enrollment status for groups and individuals. * Monitor license and credential expiration dates and advise staff members of required “renew” by dates. * Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. * Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. * Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance * Complete revalidation requests issued by government payers. * Credential new providers and re\-credential current providers with hospitals at which they hold staff privileges. * Work closely with the Director of Revenue Cycle and billing staff to identify and resolve any denials or authorization issues related to enrollment \& credentialing. * Performs and assists with other department duties as required. **Knowledge, Skills and Abilities Required:*** Meticulous follow\-through of delegated tasks, including follow\-up with staff to ensure comple