Credentialing Specialist

Rendr; New York (NY); On-site; USD 60,000 - 82,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

401k with Company Match

Paid Time Off

Paid Holidays

Health Savings Account

Annual Performance Bonus

Job summary

A leading multi-specialty medical group in New York is seeking a Credentialing Specialist to manage provider credentialing processes. This role requires over 4 years of credentialing experience in healthcare and strong organizational skills. Benefits include medical insurance, a 401k plan with a company match, and a competitive salary. Join a team committed to kindness and community impact as you help maintain compliance and support our providers in delivering quality care.

Qualifications

• 4+ years related credentialing experience in a healthcare setting.
• Ability to work effectively with clinical leadership and site operations.
• Ability to work with clinical leadership and site operations.

Responsibilities

• Complete primary source verification for delegated payer contracts.
• Prepare audited credentialing files for Committee Review.
• Track provider updates and changes according to payer credentialing guidelines.
• Manage continuing education & training requirements.
• Maintain working knowledge and ensure compliance with credentialing standards.
• Monitor hospital affiliations and ensure timely updates and renewals.
• Review CAQH profiles within 90 days for assigned providers.
• Maintain knowledge of payer requirements and credentialing standards.
• Serve as primary payor contacts for communications.
• Document data in applicable software/databases.
• Assist providers and revenue cycle teams with credentialing issues.
• Attend Health Plan meetings as needed.
• Perform other duties as requested by Credentialing Manager.

Skills

Excellent time management

Strong interpersonal skills

Ability to manage competing priorities

Organizational skills

Fast-paced environment adaptability

Tools

CAQH

Job description

Discover Better Health Careers with Rendr!

Who We Are

Rendr is the leading primary care focused, multi-specialty medical group dedicated to serving the Asian community in New York City. We strive to provide world-class, value-based health care with kindness at more than 100 clinical offices throughout Brooklyn, Manhattan, Queens, Staten Island, and Nassau County.

Why Join Rendr?

• Opportunities for professional growth and development.
• Competitive salary and benefits package. (Salary is based on previous experience and years of service.)
• Join a team that values employee, embraces diversity, and is committed to making a meaningful impact within our communities.

Benefits We Offer

• Medical, Dental, and Vision Insurance
• 401k with Company Match
• Paid Time Off
• Paid Holidays/ Floating Holiday(s)
• Health Savings Account/ Flexible Spending Account/ Dependent Care Account
• Annual Performance Bonus

Job Position

Credentialing Specialist

Essential Functions

• Complete primary source verification for delegated payer contracts
• Prepare audited credentialing files for Committee Review
• Track provider updates and changes in accordance with all payer credentialing guidelines and NCQA standards
• Prepare re-credentialing or updated provider files for credentialing committee review
• Manage continuing education & training requirements from state and payers, in coordination with operations and human resources
• Track hospital affiliations and ensure provider completes necessary updates and renewals
• Review and update as needed, each assigned providers CAQH profile within the 90-day timeframe
• Maintain working knowledge and ensure compliance with all payer requirements for documentation and credentialing standards
• Primary payor contact, ensure all communications are initiated and responded to timely
• Tracking and reporting all data and updates into applicable software / databases etc.
• Assist providers, site staff, and revenue cycle management team with any issues pertaining to credentialing and provider payer enrollment
• Participates in Health Plan meetings, as needed.
• Perform other duties and special projects as requested by Credentialing Manager

Qualifications

• 4+ years related credentialing experience in a healthcare setting
• Ability to manage competing priorities
• Excellent time management and organizational skills
• Strong interpersonal skills with ability to work effectively with clinical leadership and site operations
• Ability to work in a fast-paced environment

Rendr is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

We look forward to reviewing your application and exploring the possibility of you joining our team!