Credentialing Specialist – Market Access

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

📋 Description

• Complete the Initial Credentialing and Re-Credentialing applications to achieve in-network status with commercial payors and Managed Medicaid payors.

• Oversee and monitor application submissions through Salesforce.

• Conduct timely follow-ups with payers.

• Collaborate closely with the Market Access Team to collect essential information and documentation for network expansion efforts.

• Act as the primary contact for designated payers to address application and enrollment concerns.

• Keep track of expiration dates for assigned payers and enrollments to guarantee timely renewal and avert lapses in participation.

• Ensure adherence to payer-specific requirements as well as state and federal regulations.

⛳️ Requirements

• A preferred bachelor’s degree with a minimum of 3 years of experience in Credentialing Services.

• Certification as a Provider Credentialing Specialist (CPCS) is preferred.

• Alternatively, a minimum of 5 years of experience in Credentialing Services may substitute for a degree.

• Experience in Diagnostic Laboratory settings is preferred.

• Prior experience with State Medicaid Provider enrollment is preferred.

🏝️ Benefits

• Equal Opportunity Employer.

• Professional development opportunities.