Credentialing Specialist

spectrumbillingsolutions; United States; Hybrid; USD 50,000 - 70,000; Full time

Benefits offered by this job

Healthcare benefits (medical, dental &

Vision

401K

Flexible PTO

Competitive salary

Job summary

Spectrum Billing Solutions seeks a Credentialing Specialist to join our growing team. This role handles provider credentialing, contracting, and data accuracy across CAQH and other databases, with a focus on timely communications and document management.

The position offers remote or hybrid work arrangements, competitive salary, healthcare benefits, 401K, and flexible PTO, with opportunities to grow within the organization.

Qualifications

• 1-3 years of credentialing and contracting experience.
• 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.

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 timeframesfor provider communications, enrollments, and follow-ups.
• Maintain quality working relationships with internal and external customers.

Skills

Credentialing

Contracting

Time management

Communication

Problem-solving

Organized

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 timeframesfor 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.