Credentialing Specialist

Sevita; Minneapolis (MN); Remote; USD 55,000 - 75,000; Full time

Job summary

A leading provider in home and community-based specialized healthcare seeks a Credentialing Specialist. This role involves securing insurance contracts, analyzing financial aspects, and fulfilling enrollment application requirements. Candidates should be proactive and possess relevant experience in a healthcare setting. Join Sevita and contribute to the mission of providing quality services to individuals with diverse needs.

Benefits

401(k) with company match

Paid time off and holiday pay

Comprehensive benefits package

Qualifications

• Bachelor’s degree preferred.
• Three to five years’ experience with contracts and health insurance industry.
• Reliable, responsible attitude and a compassionate approach.

Responsibilities

• Identifying and securing insurance contracts.
• Conducting contract negotiations.
• Maintaining database of licenses and accreditation forms.

Skills

Analytical skills

Communication skills

Negotiation

Education

Bachelor’s degree in Rehabilitation Administration

Business Administration

Job description

Join to apply for the Credentialing Specialist role at Sevita

Join to apply for the Credentialing Specialist role at Sevita

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SEVITA provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You’ll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived.

Contracts and Payor Specialist - REMOTE

The Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assists with the development of potential relationships with strategic partners and creates measurable business results for various markets.

Contracting and Credentialing

• Works in partnership with Program Directors and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts
• Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts
• Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants
• Conducts rate and contract negotiations
• Describes CFS programs to potential contract sources
• Communicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are met
• Completes contract related credentialing and enrollment application requirements
• Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment application
• Oversees Single Case Agreement process within the Admissions Teams. May take lead in difficult single case negotiation
  
  

Other Duties

• Communicates contract executions and requirements to all internal departments
• Facilitates resolution of contract related issues with billing and collections team
• Performs other related duties and activities as required
  
  

Qualifications

• Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred
• Three to five years’ experience with contracts, managed care, and health insurance related industry preferred
• A reliable, responsible attitude and a compassionate approach
• A commitment to quality in everything you do
  
  

Why Join Us?

• Full time position
• Full compensation/benefits package for employees working 30+ hours/week
• 401(k) with company match
• Paid time off and holiday pay
• Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers
• Enjoy job security with nationwide career development and advancement opportunities
  
  

We have meaningful work for you – come join our team – Apply Today!

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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