Credentialing Specialist

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

📋 Description

• Ensure the maintenance of accurate and up-to-date information for all providers.

• Complete provider/payor enrollment forms, monitor their progress, and conduct follow-ups as necessary.

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

• Manage provider data in online systems such as NPI and CAQH.

• Gather information from providers and collaborate with the CVO to process credentialing requests.

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

• Audit and verify that practice address information with health plans is accurate.

• Uphold the confidentiality of provider information.

• Execute additional tasks as assigned.

⛳️ Requirements

• A high school diploma or GED equivalent is mandatory.

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

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

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

• Familiarity with health plans and the credentialing requirements of other state agencies.

• Strong research and data analysis abilities.

• Capability to work independently with minimal oversight.

• Commitment to maintaining the confidentiality of provider information.

• Exceptional oral communication skills and a professional phone demeanor.

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

• CPCS certification is preferred, but not mandatory.

🏝️ Benefits

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

• Generous Paid Time Off (PTO) plans.

• Paid holidays.

• A focus on teamwork, personal growth, and service to others, emphasized through company values.