Remote Credentialing & Contract Specialist

Nrg-Mgmt-LLC; Town of Florida (NY); On-site; USD 46,000 - 50,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Health insurance

Life insurance

Paid time off

Tuition reimbursement

Vision insurance

Job summary

NRG Management is seeking a full-time remote Credentialing and Contract Specialist in Boca Raton, FL area. The role handles credentialing, re-credentialing, and privileging for medical staff in mental health and addiction services, enrolling providers with payers and maintaining licensure and credentialing documentation.

Experience in credentialing and provider enrollment is required. Preferred CPCS certification; degree in Healthcare Administration or equivalent experience; 2 years

Qualifications

• Healthcare Administration degree preferred or meets experience requirements.

Responsibilities

• Perform all aspects of credentialing, re-credentialing, and privileging for applicable medical staff.
• Maintain CAQH, PECOS, and NPI registry for IHTC providers.
• Maintain copies of state licenses, CSR and DEA certificates, malpractice coverage, and other credentialing documents.
• Track license and certification expirations to ensure timely renewals.
• Coordinate with Billing Manager to attach providers to contracts.
• Update provider demographics with payers as needed.
• Audit health plan directories for current provider information.
• Develop and implement new contracts.
• Support development of new business, acquisitions, and facility expansion.
• Influence contract strategy in negotiations with third-party payers.
• Lead discussions with payers on rates and language under guidelines.
• Maintain positive relationships with payer networks.
• Communicate contract requirements/changes internally after execution.
• Review solicitations and prepare routine responses for proposals and amendments.

Education

Healthcare Administration degree

Job description

NRG Management is seeking a full-time remote Credentialing and Contract Specialist in Boca Raton, FL area. The role handles credentialing, re-credentialing, and privileging for medical staff in mental health and addiction services, enrolling providers with payers and maintaining licensure and credentialing documentation.

Experience in credentialing and provider enrollment is required. Preferred CPCS certification; degree in Healthcare Administration or equivalent experience; 2 years