Credentialing and Payer Contract Specialist - Remote

Overview

The Credentialing and Payer Contract Specialist is responsible for ensuring that healthcare providers are properly credentialed, licensed, and enrolled with the necessary organizations and insurance companies. This role requires meticulous attention to detail, strong organizational skills, and the ability to manage multiple tasks simultaneously.

In Short

• Manage the initial credentialing and re-credentialing process for healthcare providers.
• Ensure compliance with state and federal regulations.
• Handle the enrollment of providers with insurance companies and Medicare/Medicaid.
• Prepare for and participate in audits related to provider credentials.
• Serve as a point of contact for providers and staff regarding credentialing inquiries.
• Maintain organized and accurate credentialing files and electronic databases.
• Manage payer and managed care contracts and track renewals.
• Coordinate with payers to resolve contract-related issues.
• Support Revenue Cycle operations as needed.
• Stay updated on changes in credentialing requirements and regulations.

Requirements

• Associate’s or Bachelor’s degree in healthcare administration or related field (preferred).
• Minimum of 2-3 years of experience in credentialing within a healthcare setting.
• Experience with credentialing software and databases is preferred.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple tasks and deadlines simultaneously.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).

Benefits

• Opportunity for professional growth in the healthcare field.
• Work in a dynamic and supportive environment.
• Flexible work arrangements due to remote-hybrid nature.
• Competitive salary and benefits package.