Credentialing Specialist

Spectrum Billing Solutions; United States; Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

Close-knit team

Growth opportunities

Competitive salary

Healthcare benefits including medical,

401K

Flexible PTO

Job summary

Spectrum Billing Solutions is seeking a Credentialing Specialist to join our growing team. This role supports provider credentialing and contract applications, reviews information for completeness, and tracks progress across multiple databases including CAQH.

You will work to ensure timely enrollments and maintain strong relationships with clients and carriers. Ideal candidates have 1–3 years of credentialing experience, knowledge of commercial and government payor guidelines, and strong

Qualifications

• 1–3 years of credentialing and contracting experience.
• ABA or other behavioral healthcare experience preferred.
• Knowledge of Commercial Insurance and Government Payor guidelines.
• Ability to plan, organize, and complete work with competing priorities.
• Organized and detail-oriented with strong communication and problem-solving skills.

Responsibilities

• Complete provider credentialing and contract applications with third-party carriers and government health plans.
• Review provider credentialing and contracting information to ensure completeness and accuracy.
• Monitor applications and follow up in a timely manner.
• Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable.
• Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly.
• Meet or exceed required timeframes for provider communications, enrollments, and follow-ups.
• Maintain quality working relationships with internal and external customers.

Skills

Credentialing experience

Contracting knowledge

Attention to detail

Communication skills

Problem-solving

Tools

CAQH

Job description

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner. We are seeking to add a Credentialing Specialist to our growing team. If you are looking for a rewarding position where you can work with industry experts and actively grow in your career, this position is for you. The ideal candidate is passionate, motivated, detail-oriented and interested in gaining knowledge and new skills.

This is a remote or hybrid in-office/remote role.

Your Responsibilities:

• Complete provider credentialing and contract applications with third-party carriers and government health plans.
• Review provider credentialing and contracting information to ensure completeness and accuracy.
• Monitor applications and follow-up in a timely manner.
• Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable.
• Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly.
• Meet or exceed required timeframes for provider communications, enrollments, and follow-ups.
• Maintain quality working relationships with internal and external customers.

What we offer you:

• A close-knit team of talented and skilled individuals
• Growth opportunities within the organization
• Competitive salary
• Healthcare benefits includingmedical, dental & vision, 401K
• Flexible PTO

Qualifications:

• 1-3 years of experience in credentialing and contracting.
• Experience in ABA or other behavioral healthcare preferred.
• Knowledge of Commercial Insurance and Government Payor guidelines.
• Ability to plan, organize, and complete work with competing priorities.
• Takes accountability for personal productivity and quality of output.
• Organized anddetail-oriented with strongcommunication and problem-solving skills.