Credentialing Specialist

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.
Day Shift - 7.5 Hours (United States of America)
Job Responsibilities

- Coordinate and monitor the review and analysis of practitioner applications and supporting documentation to ensure eligibility and compliance.
- Conduct thorough background investigation, research and primary source verification of all components within credentialing/payer enrollment files.
- Identify credentialing and enrollment discrepancies that require additional investigation; facilitate appropriate follow-ups to resolve issues effectively.
- Prepare, track, and secure required practitioner signatures for enrollment files in a timely manner to avoid onboarding delays.
- Utilizes Symplr credentialing database to retrieve credentialing documents in accordance with the Health Care Quality Improvement Act.
- Collaborate with Richmond Health Network’s administration to ensure seamless information exchange during the practitioner on-boarding and off-boarding processes.
- Perform miscellaneous job-related duties and special projects as assigned.

Job Qualifications

- High school diploma or GED required.
- Proven experience in healthcare provider credentialing and payer enrollment.
- Minimum of 1 year of experience working within a physician billing or third-party payer environment.
- Strong, practitioner-focused communication skills with the ability to explain complex credentialing and enrollment processes clearly.
- Excellent organization, time management, and customer service skills.
- Absolute commitment to maintaining strict confidentiality regarding proprietary information and provider files.
- Proficient with data entry, MS Office Suite (Word, Excel, Outlook, PowerPoint), and Symplr credentialing software.
- Ability to thrive under tight deadlines and manage a high-volume workload efficiently.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!