Credentialing Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $45k - $55k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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CIVIE

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

🏥 Healthcare

🤖 Artificial Intelligence

☁️ SaaS

Healthcare • Artificial Intelligence • SaaS

CIVIE is a healthcare technology company that provides an AI-powered, cloud-based radiology operations suite and modular products for radiology groups, hospitals, and teleradiology services. Its offerings include a Radiology Information System (RIS), Picture Archiving and Communication System (PACS), vendor-neutral archive (VNA), AI-enabled workflow and dictation (CIVR), revenue cycle management (RCM), business intelligence, interoperability and patient experience tools, plus ancillary services like credentialing, authorizations, AR recovery, and IT support. CIVIE’s platform aims to improve radiologist productivity, reduce costs, unify disparate imaging systems, and deliver better patient and operational outcomes.

📋 Description

• Manage the full credentialing and re-credentialing process for assigned providers • Conduct primary source verification of licenses, board certifications, education, training and work history • Submit and track credentialing applications to health plans, payers and provider networks • Maintain accurate provider records in credentialing databases and electronic systems • Monitor expiration dates for licenses, DEA registrations, malpractice insurance and certifications to prevent lapses • Ensure compliance with state, federal and accreditation standards • Review provider applications for completeness and accuracy, and follow up on missing or incomplete documentation • Respond to payer inquiries and assist in resolving credentialing discrepancies or denials • Communicate credentialing status updates to providers and internal stakeholders • Identify opportunities to improve the efficiency, accuracy, and timeliness of credentialing processes

🎯 Requirements

• High School diploma or equivalent • 2+ years of relevant credentialing experience • Working experience in CAQH, PECOS, Availity, Verity • Willingness to learn and build a process around onboarding new clients for payer claim enrollment and EFT enrollments • Self-driven and motivated with great attention to detail • Able to manage multiple priorities and meet deadlines • Comfortable with multitasking and working in a tech-driven environment • Organized and focused while navigating multiple systems • Able to handle sensitive and confidential information with discretion • Certified Provider Credentialing Specialist (CPCS) certification preferred

🏖️ Benefits

• Paid vacation, sick time, and personal days • 11 company paid holidays • Health, dental, and vision benefits, with employer HSA contribution • 401(k) company match and profit sharing • STD, LTD and life insurance • Quarterly UberEats voucher • Monthly Fringe benefits • Professional development stipend

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