Credentialing and Support Specialist

Ensign Services; Nashville (TN); Remote; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical/dental/vision coverage

Life insurance

401(k) with company match

Sick/vacation plans

Learning & development

Job summary

Ensign Services is seeking a Credentialing and Support Specialist for the Managed Care Team. This full-time, non-exempt role handles credentialing and re-credentialing across locations, coordinating with Legal, HR, and Compliance to ensure timely, accurate processing and reporting to health plan partners.

The ideal candidate brings at least 2 years of facility credentialing experience and strong organizational, confidentiality, and communication skills to support contracting and market-specific

Qualifications

• Minimum 2 years of facility credentialing and contracting experience in Senior Living/Skilled Nursing or Long-Term Care.
• Ability to manage projects and multi-task across markets.
• Maintain strict confidentiality and demonstrate integrity.
• Strong written and verbal communication; professional demeanor.

Responsibilities

• Ensure compliance with policies, bylaws, and regulations for credentialing.
• Process credentialing applications and re-credentialing according to requirements.
• Maintain licensing, CLIA, COI, surveys and related docs.
• Coordinate with Legal, HR and Compliance to verify information.
• Manage credentialing database and maintain records.
• Represent facilities professionally to health plans and partners.
• Support contracts team with special projects and documentation.
• Collaborate with Contract Resources to file and maintain contract data.

Skills

Organizational skills

Multi-tasking

Time management

Confidentiality

Written & verbal communication

Teamwork

Accountability

Problem solving

MS Office proficiency

PDF editing

Education

Post-Secondary degree

Tools

MS Office Suite

PDF editing

Job description

Employment Type: Full Time, Non-exempt employee.

Compensation: $19.23-$27.00 DOE; may be eligible for bonus.

Location: Remote - Applicants must reside in North Carolina, South Carolina, Tennessee, Alabama, or Florida .

About the Company

Ensign Services, Inc. (“ESI”) is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered nationalleaders in the fast-growing post-acute care industry. ESI provides service and support to over 398 facilities in the long-term care continuum that employ over 60,000 employees.

ESI is known as the “Service Center” and provides the facilities and leaders it serves with “back-office” support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.

We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership (“CAPLICO”) seriously. We want an individual in this role who will demonstrate these values through actions and words.

About the Opportunity:

Ensign Services, Inc. is currently seeking a full time, experienced Credentialing and Support Specialist for our Managed Care Team. This role is responsible for all aspects of credentialing and re-credentialing for our locations across the organization. Coordinates and supports compliance regarding applications. Acts as the liaison between our entities and our health plan partners. Supports the Contracting team with administrative management and project work.

Duties and Responsibilities:

• Guarantees full compliance with all applicable policies, procedures, bylaws, rules and regulations, accreditation standards and regulations for the processing of applications for initial credentialing and re-credentialing.
• Ensures all applications and requires for credentialing are processed accordingly to regulations and policies as outlined by provider.
• Confirms the seamless and timely flow of credentials information in order to meet deadlines.
• Coordinates with our Legal, HR and Compliance Departments to verify and document pertinent information.
• Maintains copies of current state licenses, CLIAs, COIs, surveys and other required credentialing documentation.
• Coordinate and maintain the credentialing management database.
• Expected to represent our facilities and company professionally to all health plans and external partners.
• Assist Managed Care Resources and team with special projects as assigned including completion of contract summaries, contract catalogue and other market specific
• projects
• Coordinates with Contract Resource to file and maintain contract database.

Qualifications, Skills and Abilities:

• Proven strong organizational skills and attention to detail. These are absolutely necessary and critical for success in this role. Ability to multi task as this position will cover multiple markets and facilities.
• Critical thinking, to analyze a project/problem and work through it effectively. Proven record of ability for time management and prioritization of work/projects
• Demonstrated professionalism and exceptional interpersonal skills.
• Ability to adhere to strict confidentiality guidelines and operate with the utmost integrity and discretion.
• Strong written and verbal communication skills required.
• Teamwork orientation.
• Able to follow through with delegated tasks and accountability.
• Resourcefulness in problem solving.
• Demonstrated ability with intermediate to advanced computer skills including proficiency in MS Office applications (Excel, Word, Outlook, PowerPoint) along with PDF editing. Proficiency with learning new software.
• Dedicated to results and thorough follow up.
• Knowledge of commonly used credentialing concepts, practices and procedures.
• Excellent time management and multi-tasking abilities.
• Demonstrated ability to function independent with minimal direct supervision.

Desired Qualifications:

• Minimum 2 years of facility credentialing and contracting experience in Senior Living/Skilled Nursing or Long-Term Care community.
• Proven track record of managing projects.
• Post-Secondary degree preferred.

Additional Information:

Any offer of employment may be contingent upon the successful completion of job-related post-offer requirements, which may include background checks, reference checks, and/or other screenings or examinations as permitted by applicable law.

What We Offer

We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee’s professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com

This company is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.