Credentialing Specialist

Rippling; United States; Remote; USD 45.000 - 55.000; Vollzeit

Benefits dieser Stelle

Paid vacation, sick time, and personal

Health, dental, and vision benefits, H

401(k) company match and profit share

STD, LTD and life insurance

Monthly fringe benefits

Zusammenfassung

CIVIE is a fully remote employer in the United States seeking a Credentialing Specialist to manage the credentialing and re-credentialing lifecycle for providers. You will verify licenses, certifications, education, and work history, and submit applications to health plans and networks, maintaining accurate records.

Strong detail-orientation, discretion, and ability to multitask in a tech-driven setting are essential.

Qualifikationen

• 2+ years of relevant credentialing experience.
• Experience with CAQH, PECOS, Availity and Verity.
• Willingness to learn onboarding for payer enrollment and EFT.
• Ability to manage multiple priorities and deadlines.
• Discretion with confidential information.
• Detail-oriented and self-driven.

Aufgaben

• 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.

Kenntnisse

Attention to detail

Multi-tasking

Organized

Discretion

Self-driven

Deadline oriented

Tech-savvy

Ausbildung

High School diploma or equivalent

Tools

CAQH

PECOS

Availity

Verity

Jobbeschreibung

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.