Credentialing Specialist - Remote

Overview

The Credentialing Specialist is responsible for coordinating, monitoring, and maintaining the external credentialing and re-credentialing processes for Clarity Clinic. This role acts as a liaison between the Credentialing Company and the Human Resources Department, ensuring compliance with state and federal regulations.

In Short

• Assist in processing initial credentialing and re-credentialing applications.
• Collect pertinent information from applicants and their malpractice insurers.
• Obtain and update provider licenses and CAQH database files.
• Maintain individual provider files for credentialing applications.
• Track credentialing status and ensure accurate internal records.
• Complete revalidation requests and credentialing applications for payers.
• Monitor compliance with laws and regulations.
• Ensure confidentiality and participate in departmental meetings.
• Identify discrepancies and conduct follow-ups.
• Adapt to changes in a professional manner.

Requirements

• High school diploma or GED.
• Minimum of 2 years of physician credentialing experience.
• Working knowledge of medical insurance industry and managed care organizations.

Benefits

• Competitive compensation based on experience.
• Comprehensive benefits package including health, dental, and vision.
• $100 Monthly Wellness Reimbursement Stipend.
• 401k match up to 4%.
• 10 days PTO + 5 Sick/Wellness Days and 6 Holidays.