* Prepares and submits provider enrollment applications and supporting documents with payers to ensure timely enrollment.

* Maintains and checks status of all pending and completed providers' applications with payers.

* Maintains and updates credentialing files which include expirables, database, and rosters.

* Responsible for the creation and maintenance to the CAQH database for the providers credentialed.

* Manages all re-credentialing request from commercial/government payers.

* Reviews new provider files for completeness and prepares and sends follow up requests.

* Responsible for access, control and maintenance of the Medicare Pecos system for NAH.

* Maintains data base/Credentialing software with updated information.

* Communicates payer credentialing status to NAH internal departments.

* Collaborates with the billing department to help identify credentialing problems with providers.

* Communicates non-responsive providers and payers to manager with documentation of request.

* Communicates enrollment status to leadership and other internal departments for scheduling and billing purposes.

* Tracks and follows-up with payers to obtain effective dates with plans.

* Communicates with departments and team members regarding high priority items as they arise.

* Maintains knowledge of managed care environment, operations, and provider contracting.

* Maintains communication with Medical staff office team members.

* Participates in claim denial management due to credentialing or managed care provider effective dates.

* Collaborates with management and staff to improve process within the department and company.

* Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

* If required for position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

* Completes all company mandatory modules and required job specific training in the specified time frame.