Insurance Credentialing and Contracting Agent, US Healthcare

🔥 10 minutes ago

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iSTA Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📦 Logistics

📣 Marketing

Healthcare • Logistics • Marketing

iSTA Solutions is your remote healthcare operations partner specializing in off-site staffing solutions. With over 20 years of experience, we focus on enhancing operational efficiency for businesses, particularly in the healthcare sector, by providing customized remote teams that take on tasks ranging from customer service to data entry. Our goal is to support organizations in scaling their operations seamlessly while achieving significant cost savings and improved productivity.

📋 Description

• Manage insurance credentialing for newly hired clinicians, updating documentation and portal profiles with individual insurers to ensure compliance and correct billing • Research insurance landscapes in new states as the company expands, identifying which insurers to prioritize for network participation • Reach out to insurance companies to understand credentialing requirements, application processes, and reimbursement rate structures • Negotiate reimbursement rates with insurers where offered rates fall below competitive benchmarks • Track credentialing and contracting progress, flagging delays or issues proactively • Maintain accurate, audit-ready records across multiple insurer portals and systems • Follow established workflows and escalate matters appropriately when required • Complete other ad hoc coordination tasks as needed

🎯 Requirements

• U.S. health insurance experience, including private insurers and Medicaid • Excellent communication skills and strong English fluency (verbal and written) • Strong critical thinking and independent problem-solving skills, particularly for the contracting/negotiation side of the role • A confident, proactive attitude - comfortable initiating contact with insurers and pushing for better terms • Detail-oriented and highly organized, with the discipline to manage multiple portals and deadlines accurately • Basic computer literacy, including MS Office and Outlook (no advanced Excel skills required) • Experience with ABA-specific insurance processes is a strong plus, but not required • Ability to work independently with minimal day-to-day supervision