Credentialing Specialist

CIVIE; United States; A distancia; USD 45.000 - 55.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Paid vacation

Sick time

Personal days

Health benefits

HSA contribution

401(k) match

Descripción de la vacante

CIVIE is an AI-powered radiology solutions company offering cloud-based information systems, PACS, and revenue cycle management. The Credentialing Specialist role is fully remote, with candidates residing in the United States.

The salary range is $45,000 - $55,000 per year, and the position focuses on coordinating credentialing and re-credentialing for healthcare providers. Responsibilities include management of the full credentialing lifecycle, primary source verifications, application

Formación

• High School diploma or equivalent.
• 2+ years of relevant credentialing experience.
• Working experience in CAQH, PECOS, Availity, Verity.
• Willingness to learn and build a process around onboarding new clients for payer claim enrollment and EFT enrollments.
• Self-driven and motivated with great attention to detail.
• Able to manage multiple priorities and meet deadlines.
• Comfortable with multitasking and working in a tech-driven environment.
• Organized and focused while navigating multiple systems.
• Able to handle sensitive and confidential information with discretion.

Responsabilidades

• Manage the full credentialing and re-credentialing process for assigned providers
• Conduct primary source verification of licenses, board certifications, education, training and work history
• Submit and track credentialing applications to health plans, payers and provider networks
• Maintain accurate provider records in credentialing databases and electronic systems
• Monitor expiration dates for licenses, DEA registrations, malpractice insurance and certifications to prevent lapses
• Ensure compliance with state, federal and accreditation standards
• Review provider applications for completeness and accuracy, follow up on missing or incomplete documentation
• Respond to payer inquiries and assist in resolving credentialing discrepancies or denials
• Communicate credentialing status updates to providers and internal stakeholders
• Identify opportunities to improve the efficiency, accuracy, and timeliness of credentialing processes

Educación

High School diploma or equivalent

Herramientas

CAQH

PECOS

Availity

Verity

Descripción del empleo

CIVIE is an AI-powered ecosystem of radiology solutions that encompass the entire patient and clinical journey, from exam ordering to image viewing, reporting, and payment. CIVIE's cloud-based product offering utilizes state of the art technology to provide an integrated radiology information system, PACS, automated speech-to-text, revenue cycle management, and vendor neutral archive. The Company's products are purpose-built to optimize revenue, increase physician productivity, and drive practice efficiencies through its innovative, cloud-based, AI-driven technology platform.

Overview

The Credentialing Specialist is responsible for coordinating and executing the credentialing and re-credentialing process for healthcare providers. This role ensures providers meet regulatory, accreditation and payer requirements while maintaining accurate and up-to-date credentialing records. The Credentialing Specialist works collaboratively with health plans, payers and providers to support timely onboarding and enrollment.

This is a fully remote position. Candidates must reside within the United States. The salary range is $45,000 - $55,000.

Your responsibilities

• Manage the full credentialing and re-credentialing process for assigned providers
• Conduct primary source verification of licenses, board certifications, education, training and work history
• Submit and track credentialing applications to health plans, payers and provider networks
• Maintain accurate provider records in credentialing databases and electronic systems
• Monitor expiration dates for licenses, DEA registrations, malpractice insurance and certifications to prevent lapses
• Ensure compliance with state, federal and accreditation standards
• Review provider applications for completeness and accuracy, follow up on missing or incomplete documentation
• Respond to payer inquiries and assist in resolving credentialing discrepancies or denialsCommunicate credentialing status updates to providers and internal stakeholders
• Identify opportunities to improve the efficiency, accuracy, and timeliness of credentialing processes

Qualifications

• High School diploma or equivalent
• 2+ years of relevant credentialing experience
• Working experience in CAQH, PECOS, Availity, Verity
• Willingness to learn and build a process around onboarding new clients for payer claim enrollment and EFT enrollments
• Self-driven and motivatedwith great attention to detail
• Able to manage multiple priorities and meet deadlines
• Comfortable with multitasking and working in a tech-driven environment
• Organized and focused while navigating multiple systems
• Able to handle sensitive and confidential information with discretion

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) certification
• Paid vacation, sick time, and personal days
• Health, dental, and vision benefits, with employer HSA contribution
• 401(k) company match and profit sharing
• STD, LTD and life insurance
• Monthly Fringe benefits

Collaborative Imaging Technology, LLC provides equal employment opportunities for all applicants and employees. All qualified applicants will be considered regardless of an individual’s race, color, sex, gender identity or expression, religion, age, national origin, citizenship, physical or mental disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, military or veteran status, or any other basis protected by federal, state or local laws.If you cannot submit your application due to a disability, please email [e-mail]; we will reasonably accommodate individuals with disabilities to the extent required by applicable law.