Provider Credentialing and Enrollment Associate

Provider Credentialing and Enrollment Associate

The Provider Credentialing and Enrollment Associate is responsible for preparing and submitting enrollment applications and tracking credentialing statuses. They will coordinate with providers, insurance companies and internal teams to ensure timely approvals and renewals. The associate plays a key role in maintaining provider data and facilitating uninterrupted participation in insurance networks.

Essential Functions/Responsibilities of the Position:

• Manage the full-cycle credentialing process for healthcare providers, including initial credentialing and recredentialing
• Prepare and submit provider enrollment applications to commercial, federal, and state payors (e.g., Medicare, Medicaid, private insurers)
• Maintain accurate and up-to-date provider records in credentialing databases (e.g., CAQH)
• Track application status and follow up with payors to ensure timely approvals
• Ensure compliance with regulatory requirements, accreditation standards, and organizational policies
• Maintain knowledge of payor enrollment requirements and updates
• Assist with contract loading and provider roster submissions as needed
• Respond to internal and external inquiries regarding provider enrollment status
• Support reporting related to credentialing and enrollment activities
• Other duties as assigned.

Position Qualifications:

EDUCATION:

• High School Diploma or equivalent General Education Development (GED) certificate
• Associate's degree preferred

EXPERIENCE (Years & Certifications): :

• 1 year experience preferred

SKILLS:

• Data entry and database management
• Document management and recordkeeping
• Experience with payer portals
• Attention to detail and accuracy
• Time management and prioritization

Position Requirements and Working Conditions:

Physical Activities - Frequency(N)Never - 0%, (O)Occasionally - 50% or (C)Constantly - 100%

Ascending or descending stairs and the like. - O

Remaining in a stationary position, often standing or sitting for prolonged periods. - C

Moving about to accomplish tasks. - O

Communicating with others to exchange information. - C

Repeating motions that may include the wrists, hands and/or fingers. - C

Travel to meet with various stakeholders - N

Assess risk, detect risk factors for site safety purposes through being aware of surrounding environment, individuals, noises, observations, etc. - O

Environmental Conditions - Frequency(N)Never - 0%, (O)Occasionally - 50% or (C)Constantly - 100%

Low temperatures. - N

High temperatures. - N

Outdoor elements such as precipitation and wind. - N

Noisy environments. - N

Hazardous conditions. - N

Poor ventilation. - N

Small and/or enclosed spaces. - N

Adverse environmental conditions expected. - N

Physical Demands - Frequency(N)Never - 0%, (O)Occasionally - 50% or (C)Constantly - 100%

Sedentary work that primarily involves sitting/standing. - C

Light work that includes moving objects up to 20 pounds. - O

Medium work that includes moving objects up to 50 pounds. - N

Heavy work that includes moving objects up to 100 pounds or more. - N

EEO Statement

The Chautauqua Center is an Equal Opportunity Employer and considers all candidates for employment regardless of race, color, national origin, religion, sex, age, disability, citizenship, pregnancy, military status, marital status, sexual orientation, or any other characteristics protected by law.