Credentialing Specialist

Schedule: 8:00 AM - 4:30 PM local time

Job Summary:

The Credentialing Specialist is a key member of the Revenue Cycle Department. This role involves creating and maintaining credentialing and renewal information for Workit Health providers.

Core Responsibilities:

• Follow and maintain credentialing and clinic licensure policies and protocols
• Ensure reports on the credentialing status of providers are up-to-date and accurate
• Ensure all clinic information is accurate within payer directories
• Process applications, verify information, research application details, and ensure processes are accurate and completed promptly
• Maintain up-to-date data for each provider in the credentialing database and online systems
• Monitor staff credentials and licenses
• Collaborate with the Credentialing Manager and billing staff to identify and resolve denials or authorization issues related to provider credentialing
• Complete revalidation requests issued by payers
• Maintain a positive and optimistic attitude
• Perform other tasks as assigned

Qualifications:

• 2-3 years of Billing and Credentialing experience
• Deep knowledge of HIPAA standards of operations
• Familiarity with major payer portals and CAQH management
• Ability to communicate clearly and concisely via email, Slack, and face-to-face
• Proven aptitude for collaboration inside and outside of the department
• Ability to bring organization and precision to complex datasets
• Ability to use technology at an appropriate level for the role
• Access to consistent, high-speed internet access
• Ability to work independently and meet deadlines