Credentialing Analyst

Job not on LinkedIn

🕒 September 24

🏄 California – Remote

🏄 California – Remote

💵 $38 - $41 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 3%

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Amm

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 1985

🤝 B2B

🔧 Hardware

⚡ Energy

B2B • Hardware • Energy

Amm is a Marseille-based specialist in marine and industrial automation, measurement and control systems. For 30 years the company has provided engineering, installation, maintenance and repair services worldwide for merchant shipping, yachting and industrial customers (including the French Navy). Amm supplies and services measurement and safety instruments (temperature, pressure, flow, level, speed), programmable controller-based systems, remote engine and cargo monitoring, and repairs electric motors & alternators; it also handles refits and onboard automation, ballasting, oil/water detection and other marine safety systems. The company operates as an authorized agent for multiple marine equipment brands and maintains facilities and projects on diesel engines, generator sets, boilers, turbines, separators and auxiliary propulsion systems.

📋 Description

• Perform initial credentialing and recredentialing in accordance with NCQA standards, health plan requirements, and company policies • Conduct primary source verification of licensure, DEA, board certification, education and training, work history, malpractice history, and sanctions/exclusions • Assemble provider profile intake documentation and enrollment applications for payer submission • Provide one-on-one provider support sessions as needed • Prepare audit-ready credentialing files for Credentialing Committee review • Track files through approval, submission, and directory listing • Collect and verify malpractice insurance certificates and tail coverage documentation • Manage expirable licenses, DEA registrations, board certifications, and certificates of insurance with proactive renewal outreach • Coordinate CAQH profile setup, maintenance, and attestations • Maintain separation-of-duties and conflict-of-interest safeguards • Prepare, submit, and track state medical license applications and renewals across multiple states • Manage DEA and state controlled-substance registrations, including fingerprinting and licensing-board correspondence • Guide newly employed physicians through licensing and credentialing prerequisites • Ensure timely processing of provider credentialing and payer enrollment • Reconcile payer rosters against internal provider data and employment/sub-contractor status • Perform quarterly Operations Reconciliation of provider rosters, enrollment status, and directory listings • Maintain the provider onboarding and credentialing status tracker • Report status, aging, and blockers to leadership • Review intake packets for completeness before submission • Track and report data and updates in applicable software/databases • Support delegated credentialing audits and health plan or regulatory audit preparation • Assist with payer and provider inquiries and perform department projects as needed

🎯 Requirements

• 3+ years of provider credentialing experience with a medical group, IPA, MSO, CVO, or health plan • Working knowledge of NCQA credentialing standards and primary source verification requirements • Hands-on experience with state medical board licensing and DEA registration processes • Proficiency with CAQH ProView, NPPES, PECOS, and credentialing databases/software • Strong Microsoft 365 and Excel skills • Proven ability to independently manage a high-volume pipeline with accuracy and follow-through in a remote setting • High school diploma or equivalent • CPCS or CPMSM certification (NAMSS) preferred • Multi-state licensing experience preferred; Washington, Hawaii, New York, New Jersey, or Georgia a plus • Experience in a delegated credentialing environment and supporting physicians transitioning from hospital employment to group practice preferred • Associate or bachelor's degree preferred • Bilingual (Korean or Spanish) a plus

🏖️ Benefits

• Full employer-paid HMO • Option for a flexible PPO plan • Discounted vision and dental premiums • FSAs for healthcare and dependent care costs • 401(k) • Generous PTO • 40 hours of sick pay • Paid holidays • Tuition reimbursement • Paid company outings and lunches

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