Credentialing Coordinator — Rehab & Payer Compliance

Powerback Rehabilitation; Pennsylvania; On-site; USD 23,000 - 32,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Mentorship program

CEUs via Medbridge

Visa sponsorship

Relocation assistance

Employee discounts

PowerZone recognition program

Clinicians in Action program

Job summary

Powerback Rehabilitation is seeking a Credentialing Specialist to manage payer credentialing applications and ensure NCQA compliance. You will maintain plans databases and support therapists through the credentialing process.

Role requires experience in provider credentialing, MS Office proficiency, and familiarity with CAQH/NCQA, with opportunities for professional growth and licensing sponsorship considerations.

Qualifications

• Bachelor's degree preferred or equivalent work experience.
• Two years plus experience in provider credentialing within managed care, hospital, or long term care.
• Proficient with Microsoft Office applications; willingness to learn advanced software.
• Experience with CAQH/NCQA guidelines preferred.

Responsibilities

• Facilitates the acquisition of applications from payers; evaluates requirements and forwards to territory operations for coordination by therapists.
• Reviews completed applications to ensure NCQA and regulatory/license compliance; assists therapists with completion and guidance.
• Maintains database of each health plan's credentialing requirements including renewal requirements.
• Maintains provider database consistent with NCQA standards.
• Handles correspondence with payer; updates, mailings of applications and executed agreements.
• Prepares accurate and timely reports for internal staff.
• Interfaces with senior management, vendors, IS, and operations.
• Performs other duties as assigned.

Skills

Credentialing experience

MS Office

CAQH/NCQA knowledge

Education

Bachelor's degree or equivalent

Job description

Powerback Rehabilitation is seeking a Credentialing Specialist to manage payer credentialing applications and ensure NCQA compliance. You will maintain plans databases and support therapists through the credentialing process.

Role requires experience in provider credentialing, MS Office proficiency, and familiarity with CAQH/NCQA, with opportunities for professional growth and licensing sponsorship considerations.