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In the event that a highly qualified individual applies, one who has many years of credentialing and enrollment experience as well as leadership experience we will consider elevating this position to a manager role.
Internal Number: 202025
In this vital role, you will ensure that our community is cared for by qualified and competent clinicians. You will play a vital role in ensuring access to care, by enrolling clinicians with the insurance companies that cover the services patients receive at MCHC. This is a highly detailed job, with repetitive tasks and can also provide an opportunity for process improvement. Currently, we use the support of a CVO, OCHIN, to do the heavy lifting, and our Credentialing and Enrollment Specialist to act as liaison.
Key Responsibilities:
- Verify and maintain the credentials of healthcare professionals, including licenses, certifications, and educational qualifications
- Manage the enrollment process of healthcare providers with multiple payor insurance plans
- Ensure timely submission of credentialing and re-credentialing applications
- Communicate effectively with Credentialing Verification Organization, healthcare providers, insurance companies, and internal teams to resolve issues
- Monitor and track credentialing and enrollment statuses to ensure compliance with regulatory requirements
Skills and Qualifications:
- Strong organizational and administrative skills with attention to detail
- Excellent communication and interpersonal skills
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment
- Proficiency in Microsoft Office Suite
- Proven experience in healthcare credentialing and insurance enrollment preferred
- Knowledge of healthcare regulations and payor requirements preferred
The mission of MCHC Health Centers is to provide the highest quality healthcare for everyone in our communities. We ensure that there are no closed doors for those seeking primary health care at MCHC in Lake and Mendocino Counties. MCHC employs approximately 300 staff and has been stable and growing for 30 years.
Our clinics are located in rural Northern California, 2 hrs. north of San Francisco and 2 hrs. north-west of Sacramento and 1.25 hrs. from the coastal towns of Mendocino and Fort Bragg. This friendly community is rich in the arts and produces some of the best wines in Northern California. It is exactly what you picture a laid back California town in wine country to be, honest, authentic, and supportive.
MCHC is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.