Payer Credentialing Analyst – Ambulatory Infusion

Option Care Home Health LLC; Bannockburn (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Option Care Health, Inc. is seeking an Analyst, Contract Credentialing to manage the payer credentialing lifecycle from initial receipt to submission for existing and new pharmacies. You will independently complete complex credentialing requests, forms, attestations, and audits.

The role involves initiating communication with third-party payers, maintaining tracking systems, and ensuring compliance with state/federal regulations. A bachelor’s degree with credentialing experience is preferred.

Qualifications

• Bachelor’s degree and at least 2 years of payer credentialing or provider enrollment experience, OR a high school diploma/GED with at least 5 years of credentialing experience.
• Experience with provider credentialing applications or provider enrollment in the medical field.
• Strong time management, prioritization, organization and meeting deadlines across multiple projects.

Responsibilities

• Complete initial credentialing and re-credentialing applications, provider information and enrollment forms for participation in commercial medical and pharmacy networks.
• Communicate with third-party payers and internal teams to resolve non-compliance.
• Maintain internal tracking for credentialing requests, submissions and renewals.
• Use internal databases and policies to complete applications; escalate questions as needed.
• Maintain knowledge of state/federal regulations and credentialing requirements.
• Generate monthly demographic reports in standardized formats for internal customers.
• Respond to credentialing inquiries promptly and escalate as needed.
• Facilitate signature process for third-party payer agreements and letters of agreement.
• Complete credentialing/demographic information in contractual documents.
• Maintain relationships with Operations, Legal, Sales and other departments involved with payer contracts.
• Assist with ad hoc projects and tasks as assigned.

Skills

Time management

Detail oriented

Relationship building

Microsoft Word

Microsoft Excel

Education

Bachelor’s degree

High school diploma or GED with 5+ years credentialing experience

Tools

Microsoft Word

Microsoft Excel

Job description

Option Care Health, Inc. is seeking an Analyst, Contract Credentialing to manage the payer credentialing lifecycle from initial receipt to submission for existing and new pharmacies. You will independently complete complex credentialing requests, forms, attestations, and audits.

The role involves initiating communication with third-party payers, maintaining tracking systems, and ensuring compliance with state/federal regulations. A bachelor’s degree with credentialing experience is preferred.