Credentialing and Provider Enrollment Specialist

Centurion Anesthesia provides comprehensive anesthesia coverage to ASC's and Office Based Surgery across the US. We have a hand-picked, top tier group of talented Board Certified Anesthesiologists that focus exclusively on Ambulatory and Office Based Anesthesia. In addition to providing staff, we consult on development, accreditation and maintenance of ASC and OBS certification. We implement safety programs with a team approach to ensure Patient Safety First environments in all our facilities.

For more information, please visit www.centurionanesthesia.com

We are seeking a highly organized and experienced Credentialing and Provider Enrollment Specialist to join our team. This role will focus on managing provider enrollments with Medicaid, Medicare, and commercial payers, overseeing insurance credentialing and re-credentialing processes, and ensuring compliance with all regulations. The ideal candidate will have a strong background in credentialing, excellent attention to detail, and the ability to effectively coordinate with multiple stakeholders.

• Provider Enrollment:
  Oversee the enrollment process for providers (including anesthesiologists, CRNAs) with Medicaid, Medicare, and commercial payers. Resolve any issues related to application delays, rejections, and discrepancies to ensure timely enrollment.
• Insurance Credentialing:
  Manage the credentialing and re-credentialing processes with various insurance carriers, ensuring adherence to industry timelines and regulatory requirements. Address payer-related denials effectively.
• Database Management:
  Maintain accurate records of provider credentials, licensure, and certifications. Track credentialing expiration dates and ensure timely renewals to avoid disruptions in provider status.
• Policy and Compliance:
  Develop, implement, and monitor credentialing policies to ensure ongoing compliance with internal standards and regulatory requirements. Conduct audits as necessary to assess compliance.
• Communication and Coordination:
  Act as a liaison between providers, payers, and internal teams to collect required documentation, resolve credentialing-related issues, and ensure accurate credential alignment for billing purposes.
• System Oversight:
  Manage online payer portals, update provider demographic information, and monitor reporting through the CMS NPPES system.

• Education:
  Bachelor’s degree required.
• Experience:
  A minimum of 5 years of relevant experience in credentialing or healthcare administration, specifically with knowledge of Medicaid and Medicare processes in New York and New Jersey.
• Technical Skills:
  Proficient in credentialing software and payer portals. Strong proficiency with Microsoft Office Suite.
• Skills and Abilities:
• Excellent organizational and problem-solving abilities.
• Strong attention to detail with the capacity to handle multiple tasks simultaneously.
• Exceptional written and verbal communication skills.
• Ability to work independently and as part of a team.
• Professional, positive demeanor, capable of interacting with individuals at all levels of the organization.
• Work Ethic:
  Self-motivated, capable of working under pressure, and handling challenging situations independently. Strong decision-making skills and the ability to know when to escalate issues.

Job Type:
Full-time, 9:00 AM – 6:00 PM (On-site; no remote work available).

Salary Range: $65k-$75k depending on experience. 

Benefits:
Medical, Dental, Vision, 401(k), and additional benefits.

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