Credentialing Specialist

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

📋 Description

• Execute all daily credentialing tasks and perform quality checks on credentialing files, approval dates, license expiration dates, and provider information.

• Track the status of credentialing files and relay updates to Credentialing Verification Organizations (CVO).

• Ensure precise entry of provider data, encompassing NPI numbers and CAQH profile details.

• Communicate with providers through Zendesk.

• Collaborate with CVOs and providers regarding credentialing correspondence and documentation within Fountain.

• Conduct weekly follow-ups for provider re-credentialing while managing CVO databases and Fountain files.

• Carry out quality assurance checks on uploaded clinician documents and maintain correct provider statuses.

• Assist in provider outreach and retention efforts in areas with high demand.

• Support quarterly internal and annual external CVO audits.

• Supply audit data to the Credentialing Manager and Enterprise clients.

• Review credentialed license data and follow up on any expired licenses.

• Foster relationships with Enterprise clients under delegated credentialing agreements.

• Undertake additional related tasks as assigned.

⛳️ Requirements

• 2-3 years of relevant professional experience in a highly communicative role.

• Proficient in Microsoft applications or similar software.

• Experienced with G-Suite or comparable applications.

• Bachelor’s Degree is preferred.

• Prior credentialing experience is preferred.

🏝️ Benefits

• Comprehensive Medical, Dental, and Vision plans.

• Pre-tax benefits: HSA/FSA.

• 401k Retirement Savings Program with matching contributions up to 4%.

• Optional benefits including disability, basic life, or pet insurance, etc.

• Monthly Wellness Stipend to encourage mental and physical self-care.

• Flexible PTO and a Remote First Environment.

• Regular team events, including Wellness Workshops and Team Building Activities.

• Complimentary access to Talkspace products for you and one household member, along with a friends and family discount!