Credentialing Specialist, US

ASP-RCM Solutions; Dallas (TX); Vor Ort; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

ASP-RCM Solutions is seeking a credentialing leader in the United States, ideally based in Dallas, TX. You will own every credentialing application end-to-end, review and guide the team, and negotiate payer contracts to keep clients enrolled and billing accurately.

You will work with ABA agencies, mental health practices, hospitals, and FQHCs, ensuring no missed items and strong client relationships. This is a client-facing, leadership role requiring coordination across time zones.

Qualifikationen

• Must have hands-on experience owning payer credentialing and enrollment for US healthcare providers.
• Fluent with CMS-855 forms, PECOS, CAQH ProView, and Medicaid enrollment processes.
• Experience negotiating payer contracts or rates, including single case agreements.

Aufgaben

• Own credentialing applications end-to-end for clients.
• Review and guide the credentialing team’s work.
• Negotiate payer contracts or rates on behalf of clients.
• Manage payer forms, portals, and profiles.
• Maintain specialty depth trusted by clients (ABA, mental health, hospitals, FQHCs).
• Maintain client relationships and ensure retention by avoiding missed items.
• Lead and review work across time zones.

Kenntnisse

Client-facing

Project coordination

Team leadership

Tools

CMS-855 forms

PECOS

CAQH ProView

state Medicaid enrollment

Jobbeschreibung

Credentialing is where revenue starts, and where clients quietly start to leave. A provider waiting on enrollment cannot bill, a lapsed CAQH attestation stops claims, and a fee schedule nobody has challenged in four years costs a practice money every single visit. In this role you own all of it for your clients: the application, the payer, the contract and the relationship. You serve ABA agencies, mental health practices, hospitals and FQHCs. This is not a forms desk. In the same week you will fill and file applications yourself, review and guide the work of our credentialing team, negotiate rates with a payer, and sit with a practice owner who is frustrated. You switch to whatever the client needs that day. You are the face of ASP-RCM to the client, and the client is your responsibility: if a client leaves because something was missed, that is on this seat.

What you will own:

• Every credentialing application, end to end;
• Payer forms, portals and profiles;
• Payer contract negotiation;
• Specialty depth that clients trust;
• The client relationship;
• Client retention, nothing missed;
• Transaction-level command;
• Expirables and recredentialing;
• Supervising the work

What we look for:

• Hands-on experience owning payer credentialing and enrollment for US healthcare providers, from application to effective date;
• Fluent in CMS-855 forms and PECOS, NPPES, CAQH ProView, state Medicaid enrollment and managed care applications;
• Experience negotiating payer contracts or rates, including single case agreements, with outcomes you can walk us through;
• Working knowledge of at least two of our specialties: ABA, mental health, hospitals and FQHCs;
• Client-facing experience: you have been the person a practice owner or administrator calls, and you kept the account;
• You understand the money behind credentialing: held claims, retro effective dates, timely filing and denials for providers who are not enrolled;
• Able to lead and review the work of others and also do it yourself, working with a team across time zones;
• Organised and disciplined: every application, date and follow-up logged the same day;
• Based in the United States