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Contracting and Credentialing Expert
3 weeks ago
Job Title: Contracting and Credentialing Specialist
Description:
We are looking for a skilled contracting and credentialing specialist to join our team. In this role, you will handle contracting and credentialing needs for health care providers, diagnostic laboratories, and medical facilities as preferred providers in health care networks.
Responsibilities:
- Prepare, submit, and manage contracting and credentialing applications to insurance payors across multiple U.S. states.
- Communicate with payors, clinicians, and verification bodies, track application progress, and ensure timely follow-ups and completion.
- Assist with hiring and onboarding clinicians and act as the primary point of contact for all affiliated clinicians.
- Maintain accurate records and update dashboards, tracking tools, and other documents as required.
- Alert providers of new regulations, expiring certificates, reapplications, and deficiencies in credentialing requirements.
- Work with internal teams to correct and/or amend rejected contracting applications; update internal workflows to reflect current best practices based on up-to-date payor and industry requirements.
- Train team members with varying levels of experience and seniority in contracting and credentialing processes.
Required Skills and Qualifications:
- At least 2 years experience in the US-based contracting and credentialing process for providers.
- Deeply familiar with the US medical insurance industry and have worked with multiple insurance providers through the credentialing process.
- Excellent English speaking, listening, and written communication skills and dependably high levels of responsiveness.
- Able to work autonomously with minimal supervision, report regularly, and execute work plans thoroughly.
- Highly organized and detail-oriented with strong follow-up skills.
- Comfortable using Google Workspace, tracking tools, and internal platforms.
About Us:
Our company offers a collaborative work environment, opportunities for professional growth, and a chance to make a meaningful impact. We value data-driven individuals who can wear multiple hats and excel in a fast-paced environment.
EEO Statement:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Our company is an EO employer – M/F/Veteran/Disability.
