Credentialing Specialist

We are seeking a highly motivated and detail-oriented Credentialing Specialist to support the accurate and timely credentialing and recredentialing of healthcare providers with insurance networks. This role involves working with clients directly in ensuring compliance, maintaining accurate documentation, and coordinating with insurance networks and other credentialing entities to ensure our providers are credentialed and contracted.

Benefits:

• Medical ($0 Premium!), Dental, and Vision Benefits
• Fitness Fund Reimbursement Program for gym memberships and massages
• Matching 401(K) program with 100% match
• Generous Paid Time Off program; 8 Paid Holidays
• HQ On-site amenities include Gym, Massage, Pickle Ball court, Chiropractor and Naturopath at Fife, WA HQ
• Annual Portfolio Bonus

Key Responsibilities:

Credentialing and Recredentialing Support:

• Preparing, submitting, and tracking provider enrollment applications for insurance networks and credentialing organizations.
• Ensure the accuracy and completeness of provider credentialing documentation, including licenses, certifications, and malpractice.
• Monitor and update credentialing timelines, ensuring compliance with deadlines and payer requirements.

Compliance and Documentation:

• Maintain organized credentialing records and ensure accurate data entry in credentialing software or databases.
• Assist in audits of credentialing files to verify compliance with HIPAA and other regulatory requirements.

Communication and Coordination:

• Act as a liaison between the clients and the insurance payers.
• Follow up with providers and payers to gather required information or clarify discrepancies.
• Communicate updates on credentialing processes and progress to the Senior Credentialing Specialist and management.

Administrative Support:

• Provide support during high-volume credentialing periods, including managing overflow tasks as assigned by the Senior Credentialing Specialist.
• Prepare reports and summaries of credentialing activities for review by the Credentialing Manager or team.

Work Environment:

• Remote position.
• May require flexibility during high-demand periods to meet deadlines.

If you're passionate about healthcare credentialing and looking to be part of a dynamic team, we encourage you to apply!

Required Knowledge and Skills:

• Basic knowledge of credentialing processes and healthcare regulations.
• Proficiency in CAQH profile management and NPPES/PECOS enrollment tools.
• Strong organizational skills with exceptional attention to detail and accuracy.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook/Gmail).
• Proficiency in Medicaid and Medicare Enrollments
• Familiarity with credentialing software is a plus.
• Excellent verbal and written communication skills for interacting with internal and external departments.
• Ability to multitask and work collaboratively in a fast-paced environment.

Additional Requirements:

• Education: Not required
• Experience: At least 1-3 years of Provider Enrollment and credentialing experience.
• Familiarity with credentialing software and US payer processes is an advantage.
• Attributes: Proactive, team-oriented, and capable of handling sensitive information professionally.
• EMS enrollments and/or RCM experience a plus.
• ABA enrollment and/or RCM experience a plus.