- Coordinate the medical/dental provider enrollments into all insurance plans.
- Manage credentialing and re-credentialing processes along with completing applications for respective medical/dental commercial, Medicare, and Medi-Cal plans.
- Monitor provider applications for timely approval and follow-up as needed.
- Responsible for all necessary updates including, but not limited to address changes, NPI updates, phone number updates, etc.
- Maintaining knowledge of current requirements with medical/dental plans for credentialing providers.
- Manage and maintain PAVEs portal, Availity, CAQH and other required plan portals.
- Manage and maintain vendor, insurance portal and EpicCare Link accounts (Community Hospitals, Valley Children's and Saint Agnes). This includes providing login information to appropriate staff, removing staff, etc.
- Serve as a delegate for provider applications and review the completed application for accuracy.
- Provide plan roster updates to plans, as needed.
- High School Diploma; AA preferred.
- 2-3 years' experience in Managed Care Credentialing, Medi-Cal, and commercial plan provider enrollment.
- 2-3 years' experience with medical and dental insurance plans.
- Proficiency in typing, filing, medical terminology, and word processing.
- Knowledge of health insurance plans with the ability to navigate web portals.
- A valid California Driver's License and clean driving record with the ability to be insured under CVIH's automobile insurance.
- An awareness and keen appreciation of, or willingness to learn, Indian traditions, customs and socioeconomic needs. Ability to meet and deal effectively with Indian health organizations consisting of numerous tribes with varied cultures. Tact, courtesy, discretion, resourcefulness, and good judgment in handling functions of a sensitive nature.
- "Safety Sensitive" positions are subject to random drug testing and are required as a condition of continued employment.
-
Credentialing Enrollment Specialist
5 hours ago
Central Valley Indian Health Clovis, United States· Central Valley Indian Health, Inc. (CVIH) is seeking qualified candidates for the position of Credentialing Enrollment Specialist. The incumbent will be responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process in medical and dent ...
-
Program Specialist
5 days ago
KinderCare Learning Companies Clovis, United StatesFutures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with the Gallup Exceptional Workplace Award, we offer a variety of early education and child ...
-
Program Specialist
1 week ago
KinderCare Education Clovis, United StatesFutures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with the Gallup Exceptional Workplace Award, we offer a variety of early education and child ...
-
Program Specialist
1 week ago
KinderCare Learning Companies Clovis, United StatesFutures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with the Gallup Exceptional Workplace Award, we offer a variety of early education and child ...
-
University of California Agriculture and Natural Resources Fresno, CA, United StatesCFHL Community Nutrition Educator Fresno, CA, Job ID 60472 · University of California Agriculture and Natural Resources · Join our statewide and national networks of nutrition and health educators who receive high-quality training and hands-on support so that together we can mak ...
-
Support Officers
2 weeks ago
BayMark Health Services Fresno, CA, United StatesCertified Peer Support Specialist, SOR 3 Hub and Spoke Grant · The Certified Peer Support Specialist will follow best practices to provide peer support services as part of a multi-disciplinary team to persons with mental illness and/or substance abuse problems. The Peer support ...
-
Direct Market Manager
4 days ago
ThinkTank LLC Fresno, United StatesJob Description · Job DescriptionThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in Fresno, CA. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new customer ...
-
Direct Market Manager
4 days ago
ThinkTank LLC Fresno, United StatesJob Description · Job DescriptionThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in Fresno, CA. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new customer ...
-
Research Specialist II
3 days ago
CEDARS-SINAI Fresno, United States Full timeJob Description · Come join our team Cedars-Sinai Pediatrics is seeking a dynamic Sr. Research Specialist to join as lead lab scientist & lab manager for the new Cedars-Sinai Rowitch Lab. · Under the direction of Professor David Rowitch, MD, PhD, the Rowitch Lab investigates over ...
-
Direct Market Manager
5 days ago
ThinkTank LLC Fresno, United StatesJob Description · Job DescriptionThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in California - Fresno. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new ...
-
Eligibility Specialist
4 days ago
Innovative Integrative Health Fresno, United StatesJob Type · Full-time · Description · Who We Are · Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible? · Fresno ...
-
Full Time Peer Support Specialist
2 weeks ago
BayMark Health Services Fresno, CA, United States Full timeCertified Peer Support Specialist, SOR 3 Hub and Spoke Grant The Certified Peer Support Specialist will follow best practices to provide peer support services as part of a multi-disciplinary team to persons with mental illness and/or substance abuse problems. The Peer support Sp ...
-
Infant Teacher
1 week ago
Fresno County Office Of Education Fresno, United StatesAbout the Employer · Consider the Office of the Fresno County Superintendent of Schools ("FCSS") for a meaningful career and work with a team of caring, highly skilled professionals. FCSS collectively supports strong academic programs, career technical education and the arts for ...
-
Infant Teacher
1 week ago
California Department of Education Fresno, United StatesAbout the Employer · Consider the Office of the Fresno County Superintendent of Schools ("FCSS") for a meaningful career and work with a team of caring, highly skilled professionals. FCSS collectively supports strong academic programs, career technical education and the arts for ...
-
Field Marketing Specialist
1 week ago
U.S. Venture Fresno, United StatesPOSITION SUMMARY · To support, maintain and grow the Tire One dealer marketing program. This role works closely with the outside sales team by educating and engaging strategically-identified prospective dealers on the benefits of the program and managing all enrollments. Once en ...
-
Intake Specialist
1 week ago
Innovative Integrative Health Fresno, United StatesJob Type · Full-time · Description · Who We Are · Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible? · Fresno ...
-
Specialist - medical equipment services
1 week ago
Cedars-Sinai Fresno, CA, United States Full timeCedars-Sinai Pediatrics is seeking a dynamic Sr. Research Specialist to join as lead lab scientist & lab manager for the new Cedars-Sinai Rowitch Lab. · Under the direction of Professor David Rowitch, MD, PhD, the Rowitch Lab investigates overlapping mechanisms in glial developm ...
-
outside sales representative
1 day ago
YourCorporateRecruiter Fresno, United StatesJob Description · Job DescriptionThe client provides life-extending health care to seniors who need it most. Our model of care is unique, in that we are the health plan and provider of primary care services that support our participants to stay in their homes rather than going in ...
-
Outside Sales Representative
15 hours ago
WelbeHealth Fresno, United StatesJob Description · Job DescriptionWelbeHealth provides life-extending health care to our most vulnerable seniors. Our PACE model of care is unique, in that we are the health plan and the provider of primary care services that allow our participants to stay in their homes rather th ...
-
Center Director II
1 week ago
Fresno County EOC Fresno, United States* * * TRANSCRIPTS MUST BE UPLOADED IN ORDER TO BE CONSIDERED FOR THIS POSITION * * * · SUPERVISORY RESPONSIBILITIES · Teachers, Teacher Assistants, Bus Drivers, Custodians, Food Services Assistants and Inclusion Assistants indirectly. · SUMMARY · Overall responsibility for the op ...
Enrollment Specialist - Clovis, United States - Central Valley Indian Health
Description
Central Valley Indian Health, Inc. (CVIH) is seeking qualified candidates for the position of Enrollment Specialist. The incumbent will be responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process in medical and dental insurance plans, including but not limited to Medi-Cal, Medi-Cal Managed Care, Medicare, and commercial insurance. This position will also manage staff access to various provider portals required by those plans. This is a "Safety Sensitive" position and responsible for HIPAA compliance.
PRIMARY RESPONSIBILITIES:
Candidates must submit the Central Valley Indian Health employment application in order to be considered for the position.