Credentialing Specialist

FedPoint; Portsmouth; Hybrid; GBP 33,000 - 49,000; Full time

Job summary

A leading benefits marketplace company is seeking a highly organized and detail-oriented Credentialing Specialist to join their Care Coordination Department. This full-time role is crucial for coordinating provider credentialing and ensuring compliance. The ideal candidate has strong organizational skills and proficiency in Microsoft Office, with a preference for experience in managed care. This position offers a hybrid work arrangement with numerous benefits including generous PTO and a 401k plan.

Benefits

Generous 401k plan

Bonus opportunity

Paid time off (PTO)

Health, dental, vision, disability, life insurance

Parental leave

Tuition reimbursement

Volunteer program

Comprehensive wellness program

Qualifications

• Experience in provider credentialing within managed care, Medicare Advantage, or long-term care is preferred.

Responsibilities

• Review, validate, and process provider credentialing and licensing requests.
• Maintain accurate provider data within the system to ensure integrity and compliance.
• Coordinate provider and claimant requests for EFT set-up, maintenance, and updates.
• Manage all necessary correspondence with providers.

Skills

Strong organizational skills

Attention to detail

Proficiency in Microsoft Office Suite

Excellent written communication

Excellent verbal communication

Ability to work independently

Ability to work in a team

Education

High school diploma or equivalent

Job description

Overview

FedPoint aims to foster an engaging environment that promotes career growth and work-life balance, offering professional development, wellness programs, and volunteer opportunities to put employees on a positive path to success.

About FedPoint FedPoint creates and operates digital benefits marketplaces that help federal and military customers understand, select, and use their benefits. A subsidiary of John Hancock Life & Health Insurance Company, FedPoint was founded in 2002 and is headquartered in Portsmouth, NH.

Our mission
Create and deliver world-class benefits experiences for our customers, clients, and business partners.

FedPoint is seeking a highly organized and detail-oriented Credentialing Specialist to join our Care Coordination Department. This full-time position plays a critical role in ensuring providers are properly credentialed, licensed, and enrolled in accordance with established guidelines, policies, and procedures.

Position Overview
The Credentialing Specialist is responsible for coordinating all aspects of provider credentialing and re-credentialing, maintaining accurate provider data, and ensuring compliance with organizational and regulatory requirements. This role also manages provider enrollment for electronic funds transfer (EFT) and assignment of benefits (AOB), while serving as a key point of contact for provider communications.

Responsibilities

• Review, validate, and process provider credentialing and licensing requests.
• Maintain accurate provider data within the system to ensure integrity and compliance.
• Coordinate provider and claimant requests for EFT set-up, maintenance, and updates.
• Process assignment of benefits (AOB) requests, updates, and revocations.
• Manage all necessary correspondence with providers, both written and telephonic.
• Collaborate with care coordinators to ensure provider eligibility and compliance with plan and state requirements.

Qualifications

• High school diploma or equivalent required; experience in provider credentialing within managed care, Medicare Advantage, or long-term care is preferred.
• Strong organizational skills and proven attention to detail.
• Proficiency in Microsoft Office Suite.
• Excellent written and verbal communication skills.
• Ability to work independently and in a team environment.
• Schedule: Full-time, 40 hours per week
• Work Arrangement: Hybrid (2 days per week onsite in Portsmouth, NH)

About FedPoint

FedPoint creates and operates digital benefits marketplaces that make it easy for our millions of federal and military customers to understand, select, and use their benefits. A subsidiary of John Hancock Life & Health Insurance Company, FedPoint was founded in 2002 and is headquartered in Portsmouth, NH. To learn more, visit fedpointusa.com.

Benefits & Why Join Us

• Generous 401k plan: 100% match of employee contribution, up to a maximum of 6% salary, vests immediately.
• Bonus Opportunity: Qualifying employees can earn up to 7% of their salary, based on company performance. (Inquire about eligibility with our recruiter)
• Lots of paid time off: 3 weeks vacation, 7 sick days, 3 personal days, and 12 paid holidays.
• Competitive benefits include health, dental, vision, disability, life, legal, flexible spending account (FSA) and Health Savings Account (HSA) options.
• 6 weeks fully-paid parental leave
• Tuition reimbursement program to support career goals.
• Corporate giving and matching gifts program.
• Volunteer program: Paid time off to volunteer and company-organized volunteering opportunities.
• A wide variety of personal, professional, and career development programs.
• Comprehensive wellness program offering resources and activities across career, financial, mental, emotional, physical, social, and community well-being.

All offers of employment with FedPoint are conditional upon satisfactory completion of a pre-employment background check.