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Franciscan HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in credentialing processes, including payer enrollment and application management, while ensuring compliance with healthcare regulations. Strong organizational skills and attention to detail support effective communication with internal and external stakeholders.
Highest-signal resume keywords
Payer Enrollment ExperienceCredentialing Process ManagementMicrosoft Office Suite ProficiencyElectronic Health Record (EHR) Systems ExperienceHealthcare Regulations Familiarity
About the role
Key responsibilities & impact- Track and document credentialing and application status changes with participating and non-participating payers
- Enter provider data into credentialing databases
- Fulfill provider data requests from health plan organizations
- Process re-credentialing of established physicians with commercial and managed care plans and complete CAQH attestations
- Process provider payer applications, re-applications, and attestations, including mailing, review, and database loading
- Submit applications to various payers and follow up on status
- Communicate with internal and external customers, including operational and payer calls
- Research credentialing-related denials and customer issues
- Research payer processes and online payer participation
- Compile, review, and submit credentialing and re-credentialing application files to meet federal and state standards
Requirements
What you’ll need- High School Diploma/GED
- 1 year experience in payer enrollment, credentialing, or a related field within a healthcare setting
- Strong organizational and multitasking abilities, with keen attention to detail
- Excellent communication and interpersonal skills
- Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)
- Experience with electronic health record (EHR) systems
- Familiarity with healthcare regulations and payer policies
- Travel required never or rarely
Benefits
Comp & perks- Comprehensive benefit offerings for eligible employees
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CredentialingPayer Applications ProcessingRe-CredentialingData EntryApplication Status Tracking
Soft Skills
Organizational SkillsMultitasking AbilitiesAttention to DetailCommunication SkillsInterpersonal Skills
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Healthcare SettingPayer PoliciesCAQH AttestationsFederal StandardsState Standards