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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
Sentara Health is hiring a Payor Enrollment Credentialing Specialist I for the Provider Credentialing Department.
This is a Full-time, 40 hours per week Day shift position Mon-Fri between the hours of 7:00am-5:00pm.
Responsible for ensuring that healthcare professionals and providers meet the necessary qualifications and comply with all regulatory and accreditation standards. This role involves gathering and verifying a variety of documents and information, coordinating with healthcare providers, and maintaining accurate and up-to-date credentialing files.
Education
- High School Diploma
Certification/Licensure
- CPCS – Certified Provider Credentialing Specialist (Preferred)
Experience
- Requires thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 1 year of directly related experience. Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).
Keywords: Talroo-Health Plan, Monster, LinkedIn, Credential Stream, excel, data analysis, accounts receivable, Epic, revenue cycle, billing, provider not enrolled denials, appeals, onboarding, MPI, CAQH, CVO, MCO, HMO or Hospital Based Credentialing (MSO).
Sentara prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
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