Credentialing Specialist

Equum Medical; Oregon; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

401k plan

Paid time off (PTO)

Job summary

Equum Medical is seeking a Credentialing Specialist to manage provider enrollment and credentialing for our network. You will maintain data in Modio Health, coordinate applications, and support hospital partners to ensure timely credentialing and privileging processes.

The role requires 3+ years in credentialing, CPCS preferred, and strong analytical and communication skills to operate within a dynamic high-growth healthcare technology environment.

Qualifications

• Experience with credentialing and provider enrollment.
• Ability to maintain accurate electronic files and databases.
• Proficiency in data analysis and reporting for audits.

Responsibilities

• Manages credentialing for Equum contracted providers per standards and laws.
• Maintains electronic physician files in Modio Health database.
• Handles credentialing applications from start to finish and coordinates submission.

Skills

Modio Health credentialing software

Analytical thinking

Excel reporting

Effective communication

Teamwork

Interpersonal skills

Database management

Accreditation knowledge

Credentialing procedures

Education

NAMSS CPCS certification (preferred)

3+ years credentialing experience

Tools

Modio Health

Job description

Join Equum Medical and be a driving force in revolutionizing acute care telehealth. As an innovative leader in the healthcare technology industry, Equum Medical is dedicated to transforming how patients access critical medical services. Our cutting-edge telehealth solutions empower healthcare professionals to deliver exceptional care remotely, bridging gaps in accessibility and enhancing patient outcomes. By joining our dynamic team, you will have the unique opportunity to shape the future of acute care telehealth, significantly impacting countless individuals' lives while pushing the boundaries of what's possible in modern healthcare. We also promote flexible scheduling to help maintain work/life balance and long-term career sustainability. Together, let's lead the way in providing seamless, high-quality care to patients when they need it most.

About the role:

The Credentialing Specialist reports to the MSO Manager and delivers credentialing services and privileging for our providers and contracted clients. The Credentialing Specialist handles credentialing and provider enrollment and assures timely responses. The individual ensures that accurate data needed for credentialing is obtained, maintained and current for all providers. An adaptable, roll-up-your-sleeves mindset is imperative to succeeding in this role. As an early stage and high growth organization, this role will be critical in supporting our providers and hospital partners to better enable patient care.

Responsibilities:

• Manages credentialing process for all Equum contracted providers, in accordance with company standards, Federal and State laws.
• Maintains an up-to-date and accurate electronic physician file in the company's credentialing database software (Modio Health).
• Perform all functions of the electronic or paper credentialing application process, to ensure distribution, receipt, processing, and timely delivery to health system clients.
• Owns the credentialing process from start-to-finish for all assigned physicians and hospitals, including initial physician processing, application filling, submission, follow-up.
• Prepares for and coordinates credentialing audits as needed.
• Assists with coordinating and filing FPPEs/OPPEs.
• Functions as the primary credentialing contact for an assigned group of hospital clients and physician employees and/or contractors.
• Performs miscellaneous job-related duties as assigned.

Skills and Qualifications:

• Knowledge of Modio Health credentialing software or similar software and ability to become lead user quickly.
• Ability to investigate and analyze information and draw conclusions.
• Ability to process computer data and to format and generate reports, particularly using Pivot Tables, VLookup and other basic Excel reporting functions.
• Ability to communicate effectively, both orally and in writing.
• Ability to foster a cooperative work environment.
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Database management skills.
• Knowledge of related accreditation and certification requirements.
• Knowledge of medical credentialing and privileging procedures and standards.
• Knowledge of medical staff policies, regulations, and the legal environment within which they operate.

Education and/or Experience:

• NAMSS Certification as a Certified Provider Credentials Specialist (CPCS) preferred or actively pursuing certification.
• 3+ years of experience directly related to the duties and responsibilities specified.

Benefits:

• Competitive base salary
• Benefits- medical, dental, vision, 401k
• PTO

We are an Equal Opportunity Employer, committed to a diverse and inclusive workplace. We do not discriminate against any job candidate or employee based on age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status, or pregnancy. Equum Medical respects your privacy and is committed to maintaining the confidentiality and security of your personal information.