Provider Network Specialist jobs in Concord, NH

• Bachelor's degree (B.A.) from a four-year college or university; or two years related experience and/or training.

• Certified Provider Credentialing Specialist (CPCS) is preferred.

• To perform this job successfully, an individual should have knowledge of Microsoft Office, Word, Excel and Access, as well as Credentialing systems. Provider enrollment experience is strongly preferred.

• Processes necessary documents to ensure that all appropriate practitioners and institutional groups & facilities are enrolled in government programs and are participating in company-approved managed care organizations.
• Responds to and resolve problems with provider network participation as it relates to denial of services or reimbursement.
• Maintains all internal and electronic files with appropriate provider and network participation information including the database for federal payors.
• Develops and maintains positive relationships with both internal and external customers (individual
• contacts for the government and commercial payors).
• Manages and performs critical analysis of each initial credentialing and privileging application,
• reapplication and temporary privileges for Medical Staff membership and Health Professional Affiliates (HPA) as outlined in policies.
• Processes requests for credentialing, privileging, reapplication, temporary privileges, leave of absence
• requests, additional privilege requests, staff category changes and resignations for medical staff
• membership and Health Professional Affiliates (HPA) as outlined in policies.
• Performs other duties as assigned or directed. e.g. Serves as backup to other co-workers.

As a charitable organization, we exist to meet the health needs of individuals within the communities we serve. Our mission is supported by Concord Hospital Trust, our philanthropic arm, which secures and distributes charitable gifts in accordance with donors' intentions.