Therapist Credentialing Associate II

📋 Description

• Take charge of the complete credentialing process for assigned therapists, encompassing document evaluation, primary source verification, and application readiness.

• Ensure that credentialing files comply with both internal policy standards and external payer, partner, and regulatory requirements.

• Keep precise and timely updates in HubSpot and associated credentialing systems, including CAQH and CMS-related workflows.

• Directly communicate with therapists to obtain missing information, clarify discrepancies, and provide status updates in a professional and supportive manner.

• Detect inconsistencies, errors, or gaps in credentialing documentation and take proactive measures to resolve or escalate them.

• Work in collaboration with Enrollment, QA, Therapist Success, and other cross-functional teams to facilitate timely onboarding and issue resolution.

• Engage in cross-functional or departmental projects by contributing input, updates, and incorporating feedback throughout the project lifecycle.

• Adjust to changes in tools, workflows, policies, and regulatory requirements while maintaining productivity and accuracy.

• Aid in audits, quality reviews, and process enhancements by integrating feedback and modifying workflows as necessary.

• Assist in the onboarding or knowledge sharing for Credentialing Associate I team members through informal guidance and collaboration.

⛳️ Requirements

• 1 to 3 years of experience in healthcare credentialing, provider enrollment, or a closely related operational role.

• Proven proficiency with credentialing systems and tools, including CRM platforms, CAQH, and CMS-related processes.

• Strong attention to detail with a consistent record of delivering accurate and compliant work.

• Effective written and verbal communication skills, with the ability to clearly explain complex requirements to therapists and internal partners.

• Demonstrated ability to manage multiple credentialing files concurrently while adhering to deadlines.

• Capacity to identify problems, assess root causes, and propose or implement solutions within established processes.

• Comfort in a fast-paced, evolving environment with shifting priorities.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health, dental, and vision insurance.

• Flexible working hours and remote work options.

• Opportunities for professional development and career advancement.

• Supportive team environment and collaborative culture.