Credentialing Team Lead

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

📋 Description

• Complete the credentialing and contract applications for providers with third-party carriers and government health plans.

• Review credentialing and contracting information from providers to guarantee thoroughness and precision.

• Monitor the status of applications and ensure timely follow-ups.

• Document, maintain, and verify client credentials across various databases, including CAQH and other relevant third-party systems.

• Create, update, and manage provider information within the internal credentialing system to ensure credentials are completed accurately and promptly.

• Research new guidelines and information pertaining to state regulations and payers.

• Act as a primary resource for the credentialing team.

• Assist with complex credentialing issues that may arise.

• Meet or surpass the required timelines for provider communications, enrollments, and follow-ups.

• Maintain effective working relationships with both internal and external stakeholders.

⛳️ Requirements

• 3-5 years of experience in credentialing and contracting.

• Familiarity with Commercial Insurance and Government Payer guidelines.

• Ability to plan, organize, and complete tasks amidst competing priorities.

• Takes responsibility for personal productivity and the quality of work produced.

• Highly organized and detail-oriented with excellent communication and problem-solving abilities.

🏝️ Benefits

• A supportive team of talented and skilled professionals.

• Opportunities for growth within the organization.

• Competitive salary.

• Comprehensive healthcare benefits, including medical, dental, vision, and 401K.

• Flexible PTO.