Enrollment and Contracting Specialist

What You'll Do

• Complete enrollment for new providers with applicable insurance payers and clearinghouses in a timely and accurate manner.
• Utilize Credential Stream to maintain, track, submit, and initiate provider enrollment and demographic information.
• Maintain CAQH proxy access on behalf of providers.
• Track provider, site, and contract renewals and expiration dates to prevent enrollment lapses.
• Coordinate payer revalidations, renewals, and enrollment updates.
• Establish and maintain professional relationships with insurance payer contacts.
• Serve as an organizational contact for payer enrollment and contracting questions and issues.
• Research payer requirements and develop guidelines for new provider and site agreements as needed.
• Monitor payer requirements and communicate changes to appropriate internal departments.
• Track, research, and assist with resolving enrollment-related denials, adjustments, and payer issues.
• Assist with enrollment-related appeals and payer escalations.
• Identify and escalate outstanding or pending enrollment and contract issues.
• Maintain knowledge of payer requirements and the unique regulatory and operational requirements of Federally Qualified Health Centers (FQHCs).
• Maintain patient confidentiality and comply with HIPAA requirements.
• Partner with internal departments to resolve enrollment and payer-related issues.
• Provide responsive, professional customer service to providers, coworkers, payers, and other external partners.
• Maintain a positive and professional image of Noble Community Clinics.

What We're Looking For

• High school diploma or equivalent required.
• Previous payer enrollment, credentialing, or payer contracting experience preferred.
• Strong computer skills, including proficiency with Microsoft Office applications required.
• Excellent organizational skills and attention to detail.
• Strong analytical and problem-solving abilities.
• Excellent time management skills and the ability to meet deadlines.
• Strong interpersonal and communication skills.
• CPR certification required within six months of hire.

Why Join Noble Community Clinics?

At Noble, you'll be part of a mission-driven organization focused on providing accessible, high-quality healthcare to the communities we serve. Your work will directly support our providers and help ensure patients have continued access to care.

Benefits

• 20 days of PTO (accrual starts on day one)
• 8 paid holidays
• 401(k) with up to 5% employer match
• Medical, dental, and vision insurance
• Employer paid Short- and long-term disability and life insurance