Open Roles
We are seeking a highly motivated, autonomous Credentialing Specialist with a positive attitude to join our Managed Care Operations team. This role is ideal for a detail-oriented professional who thrives in a fast-paced environment and excels at managing complex credentialing processes.
As a Credentialing Specialist, you will be part of a team responsible for managing provider credentialing across multiple payor types. We value individuals who can work independently while maintaining strong collaborative relationships with health plan representatives and internal stakeholders.
Prepare and process credentialing applications for all payor types including Managed Care, Medicare, Medicaid, and Workers Compensation. Maintain and utilize credentialing databases effectively, with strong proficiency in CAQH database management. Manage high-volume credentialing and recredentialing applications while meeting turnaround time goals and performance metrics. Establish and maintain relationships with credentialing representatives at various health plans. Process credentialing for multi-Tax ID entities and handle replacements efficiently.
Minimum 3-5 years of experience credentialing providers is required. Must have health plan knowledge and familiarity with credentialing all payor types. Highly knowledgeable and proficient with CAQH database, including Practice Administrator role experience. Strong MS Word, Excel, and Access skills required. Excellent organizational, interpersonal, and communication skills essential. Must be detail-oriented, motivated, and capable of managing projects to meet deadlines.
Opportunity to work with a company that values autonomy and positive attitudes. All information is kept confidential according to EEO guidelines. Join a team where your expertise in credentialing operations will be valued and utilized.