Credentialing Specialist

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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This company has sponsored H1B visas in the past.

👻 Ghost score 12%

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H2 Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🧘 Wellness

⚕️ Healthcare Insurance

Healthcare • Wellness • Healthcare Insurance

H2 Health is a provider of outpatient physical, occupational, and speech therapy services, dedicated to making a difference in the communities they serve. With a team of highly licensed therapists, H2 Health aims to help both adult and pediatric patients achieve their therapy goals while also ensuring their clinicians and staff are supported. The company operates in 11 states, offering exceptional care in a variety of therapy disciplines.

📋 Description

• Coordinate provider and facility credentialing, recredentialing, and enrollment processes with insurance payers, including Medicare, Medicaid, and commercial insurance plans. • Review credentialing information in Medallion, verifying provider details, credentialing status, and supporting documentation. • Maintain and update provider profiles in the CAQH system, including required attestations and supporting documentation. • Assist clinicians with NPI applications and updates. • Monitor professional licenses, certifications, expiration dates, and other required credentialing documentation. • Add newly hired providers to applicable insurance payer rosters and remove terminated providers as required. • Track credentialing applications, renewals, outstanding documentation, and payer enrollment status. • Communicate with clinicians, insurance representatives, and internal departments to obtain information and resolve credentialing discrepancies. • Assist clinicians with fingerprinting and other credentialing documentation. • Maintain confidential, accurate, and organized credentialing records in accordance with applicable regulations and company policies. • Support additional administrative and compliance-related tasks as needed.

🎯 Requirements

• High school diploma or equivalent preferred. • Previous experience in medical office administration, healthcare credentialing, provider enrollment, or a related healthcare administrative role preferred. • Familiarity with CAQH, NPI applications, insurance credentialing, and payer enrollment processes preferred. • Ability to review and interpret provider credentialing records in electronic platforms, including Medallion or similar systems. • Strong attention to detail, organizational skills, and ability to manage multiple deadlines. • Excellent written and verbal communication skills. • Proficiency in Microsoft Office applications and electronic recordkeeping. • Ability to work independently in a remote setting while maintaining strong communication and accountability. • Commitment to protecting confidential provider and patient information.

🏖️ Benefits

• Medical, dental, and vision insurance • Paid time off (PTO) and paid holidays • 401(k) retirement plan • Professional development and growth opportunities • A collaborative and supportive team environment • Full-time remote work

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