Credentialing Specialist

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Ensure that all provider data is current and accurate.

• Complete enrollment applications for providers and payors, overseeing the process and following up as necessary.

• Keep records of current state licenses, malpractice insurance, and other essential provider documentation.

• Update provider details in online systems such as NPI and CAQH.

• Gather information from providers and collaborate with the CVO to submit credentialing applications.

• Monitor expiration dates for licenses and certifications to guarantee timely renewals.

• Review and confirm that practice address information is accurate with health plans.

• Safeguard the confidentiality of provider data.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• A high school diploma or equivalent GED is mandatory.

• Certification as a Provider Credentialing Specialist (CPCS) is preferred but not essential.

• At least two years of experience in all aspects of provider healthcare credentialing, specifically in Outpatient PT/OT/SP/ABA/Pediatric Rehab.

• Proficiency in Microsoft Outlook, Word, Excel, and Access.

• Experience with credentialing software and collaboration with a CVO and external vendors.

• Strong verbal communication skills and a professional phone demeanor.

• Familiarity with quality customer service and relationships with insurance carriers and field operators.

• Understanding of health plans and state agency requirements for credentialing.

• Capability to research and analyze data effectively.

• Ability to work autonomously with limited supervision.

• Commitment to maintaining the confidentiality of provider information.

🏝️ Benefits

• Eligibility for a comprehensive benefits package starting within your first month of employment.

• Generous Paid Time Off (PTO) plans.

• Paid holidays.

• Medical, dental, and vision insurance.

• 401k plan with company matching contributions.

• Disability and life insurance coverage.

• Discounts on pet insurance.

• Paid parental and maternity leave.

• Discounts on gym memberships and wellness programs.

• Complimentary mental health and financial services.

• A generous PTO program.

• Six paid holidays each year.

• Eligibility for bonuses.