Licensing & Governmental Credentialing Specialist

AdaptHealth, LLC.; Pennsylvania; Remote; USD 45,000 - 70,000; Full time

Job summary

A leading home medical equipment provider is hiring a Licensing & Governmental Credentialing Specialist for a fully remote opportunity. This role involves supporting the compliance team, ensuring correct licensing submissions per regulations, and maintaining essential records. Ideal candidates will have at least a high school diploma and relevant experience in healthcare compliance, showing strong attention to detail and knowledge of regulatory standards.

Qualifications

• High school diploma or equivalent required.
• Associate degree in business or healthcare preferred.
• Four years of accreditation or healthcare compliance experience.

Responsibilities

• Responsible for ensuring licensing submissions are executed accurately.
• Maintains working knowledge of licensing and credentialing requirements.
• Tracks licensure expiry dates and ensures compliance.

Skills

Knowledge of Licensing requirements

Regulatory compliance

Record management

Attention to detail

HIPAA compliance

Education

High school diploma

Associates degree in business or health care

Tools

Excel

SharePoint

Job description

All Jobs > Licensing & Governmental Credentialing Specialist

Licensing & Governmental Credentialing Specialist
Fully Remote • PA • Audit & Compliance

Full-time

Description

AdaptHealth Opportunity – Apply Today!

At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients’ lives, please click to apply, we would love to hear from you.

LICENSING AND CREDENTIALING SPECIALIST

Position Summary:

The Licensing and Credentialing Specialist assists the Chief Compliance Officer and Compliance team with credentialing and licensing duties. Responsible for ensuring licensing submissions are executed accurately in accordance with local, state, and Federal regulations, under the guidance of the Licensing and Credentialing Manager and Chief Compliance Officer. Also responsible for ensuring records are maintained in compliance with company requirements. Submissions must occur within specified deadlines.

Job Duties:

• Essential Functions and Job Responsibilities:
• Maintains working knowledge of Licensing and credentialing requirements at the local, state, and Federal level.
• Applies for new business licenses, certifications, and registrations as required to support business operations.
• May process Medicare 855s enrollment applications, updates, revalidations, and voluntary deactivations.
• Processes state Medicaid enrollment and re-enrollment applications.
• Maintains regulatory business information such as: Ownership, officers, Employer Identification Numbers, Medicare and NPI Information.
• Processes surety bond applications, renewals, and bond claims.
• Processes Insurance certificate holder requests and insurance claims.
• Participates in Medicare Competitive Bidding related activities and contract compliance.
• Responsible for creating and tracking regulatory binders across lines of business.
• Tracks licensure expiry dates and regularly checks to ensure that professionally licensed individuals remain in “good standing” with their respective licensing entities.
• Interfaces with and influences local management to ensure Hazardous Materials laws are followed. Completes Hazardous Materials Business Plan (HMBP) program for the company.
• Creates and utilizes SharePoint and Excel databases and other reports to track compliance.
• Develop and maintain working knowledge of current HME products and services offered by the company.
• Maintain patient confidentiality and function within the guidelines of HIPAA.
• Other duties as assigned.

Requirements

Minimum Job Qualifications:

• High school diploma or equivalent
• Associates degree in business or health care preferred.
• Four (4) years of accreditation or healthcare compliance experience and/or equivalent

AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.