Credentialing Specialist

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Expressable

WebsiteLinkedInAll Job Openings

11 - 50 employees

⚕️ Healthcare Insurance

🧘 Wellness

📚 Education

💰 $15M Series A on 2022-02

Healthcare Insurance • Wellness • Education

Expressable is an online speech therapy service that offers live, 1-on-1 sessions with experienced speech therapists from the convenience of home. Catering to individuals of all ages, Expressable focuses on a range of communication needs, including speech delay/disorder, language disorder, early language development, autism spectrum disorder, and social issues. Clients are matched with therapists who provide custom treatment plans and ongoing support. With an emphasis on practice at home, Expressable delivers research-based, flexible, and effective speech therapy designed to aid swift progress in communication skills.

📋 Description

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. • Maintain accurate provider profiles on CAQH, NPPES and any other applicable profiles • Complete credentialing applications to add current and new providers to commercial, Medicaid, and Medicare payers • Work closely with current and onboarding providers to obtain all necessary information to complete the credentialing and enrollment process • Audit provider information in various systems • Follow up with payers as it relates to credentialing, enrollment, and demographic updates • Research payer processes as it relates to credentialing, enrollment, and demographic updates • Assist in identifying and resolving any denials or authorization issues related to provider credentialing

🎯 Requirements

• High school diploma or equivalent required • Hands-on experience completing and submitting credentialing and enrollment applications for commercial payers, medicaid, and medicare • Experience maintaining provider files and ensuring compliance with payer and regulatory requirements • Prior experience working directly with providers to collect, validate, and update credentialing information • Familiarity with auditing provider data across multiple systems and resolving discrepancies • Experience following up with payers regarding application status, re-credentialing, and demographic updates • Exposure to denial resolution or authorization issues related to credentialing strongly preferred • Proficiency with credentialing platforms and databases • Strong working knowledge of payer credentialing and enrollment workflows • Comfortable navigating payer portals and researching payer-specific requirements • Experience with electronic document management and maintaining compliant provider files • Proficient with standard office productivity and collaboration tools (Docs/Word, Sheets/Excel, email, shared drives, etc.)

🏖️ Benefits

• Exceptional paid time off policies that encourage and support life balance, including a winter break. • 401k matching to ensure our staff have what they need to enjoy their retirement • Health insurance options that ensure well being for the whole person and their family • Company paid life, short-term disability, and long-term disability coverage • Remote work environment that strives for connectivity through professional collaboration and personal connections