Credentialing and Billing Operations Specialist – Part-Time

Red Cell Partners, LLC.; Phoenix (AZ); On-site; USD 60,000 - 80,000; Part time

Job summary

An innovative firm is seeking detail-oriented credentialing support for a healthcare startup focused on improving senior living. This part-time, fully remote role involves managing the credentialing process for healthcare providers, ensuring compliance with regulations, and maintaining accurate records. The ideal candidate will have extensive experience in healthcare credentialing, strong organizational skills, and the ability to work independently. Join a team dedicated to enhancing the quality of care for seniors and making a significant impact in the healthcare industry.

Qualifications

• Extensive experience in healthcare credentialing and enrollment is essential.
• Knowledge of payer enrollment processes and insurance verification is crucial.

Responsibilities

• Manage credentialing and re-credentialing of healthcare providers with health plans.
• Prepare and submit enrollment applications and track their statuses.

Skills

Healthcare & provider credentialing

Payer enrollment processes

Attention to detail

Communication skills

Problem-solving

Education

Experience in healthcare credentialing

Tools

Microsoft Office (Excel, Word, Outlook)

Credentialing software

Job description

Red Cell Partners is an incubation firm building and investing in rapidly scalable technology-led companies that are bringing revolutionary advancements to market in three distinct practice areas: healthcare, cyber, and national security. United by a shared sense of duty and deep belief in the power of innovation, Red Cell is developing powerful tools and solutions to address our Nation’s most pressing problems.

Location: Remote

Reports to: VP Strategy & Operations

Work Schedule: Part-time

Company Overview:

Savoy Life is a healthcare startup focused on improving senior living. Savoy Life’s model of care aims to support senior living communities and help tie residents, their caregivers, and the providers within the community together. This is done by partnering with senior living communities to coordinate and manage clinical gaps for residents to improve these facilities’ core business drivers. We deploy our own team of clinical experts both in-person and virtually paired with technology to provide instant leverage and relief for the facilities’ staff and fill gaps in care not always met by existing providers in the community. We honor residents’ existing care team including primary care via wraparound services to give residents the high-quality care and support they deserve, on their terms.

Job Overview:

Savoy Life is seeking detail-oriented part-time credentialing support for health plan enrollments around the country. This is a fully virtual role that will largely work independently to identify processes and contacts to enable health plan enrollment for our medical group. Additionally, this role is responsible for credentialing clinical staff, managing enrollment, and handling other related administrative tasks as needed.

Key Responsibilities:

• Manage and drive the initial credentialing and re-credentialing of healthcare providers with health plans and IPA groups (Medicare, Medicaid, Commercial plans, etc.) including identifying contacts to reach out to when barriers arise.
• Prepare, review, and submit enrollment applications and supporting documentation.
• Track and follow up on application statuses to ensure timely approval.
• Maintain and update provider credentialing files in accordance with regulations.
• Communicate with insurance companies and the internal team to resolve credentialing and enrollment issues.
• Collect, review, and validate credentials for our clinical team including licenses, certifications, and education.
• Ensure compliance with federal, state, and payer-specific requirements.
• Maintain a credentialing database ensuring all required documents are up to date and complete.

Qualifications:

• Extensive experience in healthcare & provider credentialing & enrollment.
• Knowledge of payer enrollment processes, CAQH, NPPES, PECOS, and insurance verification.
• Healthcare billing experience is nice to have.
• Strong attention to detail and organizational skills.
• Ability to act proactively and problem-solving focused.
• Excellent communication skills and excel at meeting or exceeding deadlines.
• Proficiency in Microsoft Office (Excel, Word, Outlook) and credentialing software.

Compensation: $25-$35/hour.

We’re an Equal Opportunity Employer: You’ll receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, protected veteran status, or on the basis of disability.