Credentialing Specialist – Enrollment

🔥 40 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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OCHIN, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2000

💼 Consulting

🏥 Healthcare

🤝 Non-profit

Consulting • Healthcare • Non-profit

OCHIN, Inc. is a nonprofit health IT consultancy that partners with rural and community care organizations across the United States to advance equitable, whole-person care. For more than 25 years it has provided access to a shared EHR platform and integrated knowledge solutions, and it delivers Health IT, workforce training, operational/financial consulting, research, and advocacy to improve clinical quality, clinician well‑being, and sustainability for its national network of community health providers.

📋 Description

• Process initial credentialing and recredentialing applications in accordance with regulatory requirements • Review and analyze credentialing applications and supporting documents for accuracy and completeness • Validate and verify provider credentials, including licensure, DEA, specialty board, certificates and professional liability • Identify discrepancies, conduct research and follow up, and escalate unresolved issues • Complete payer provider enrollment processes and revalidations • Maintain CAQH profiles, NPPES registrations and provider data with payers • Manage plan enrollment status in the credentialing system • Perform other duties as assigned • Support member organizations on-site for new software installations when required • Travel nationally based on OCHIN business needs

🎯 Requirements

• Minimum of two (2) years of progressive experience in Credentialing and/or Provider Enrollment preferred • In-depth knowledge of credentialing, privileging and provider enrollment standards (HRSA, FTCA, TJC, NCQA, etc.) preferred • Certified Provider Credentialing Specialist (CPCS) may be required or strongly preferred • Proficiency in credentialing software and data management systems preferred • Experience in MD-Staff preferred • Advanced Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, etc.) preferred • Working knowledge of Smartsheet, including data structure, formula creation, basic workflows and automation preferred • Proven experience in client-facing roles, with ability to build relationships and communicate with diverse stakeholders preferred • Familiarity with Jira for issue tracking and task management preferred • Ability to work independently and efficiently from a home office environment • High-speed internet service • Ability to work in a distraction-free workplace • Must be legally authorized to work in the United States on a permanent basis at the time of application • Position is not eligible for employment visa sponsorship now or in the future • Candidates may be required to complete a pass/fail computer literacy assessment and a competency assessment

🏖️ Benefits

• Generous compensation package • Healthy work-life balance • Opportunity for professional advancement • Remote work from home • High Speed Internet Service requirement/support • Comprehensive range of benefits (details on OCHIN website) • Immunization support/encouragement, including COVID-19 and influenza vaccinations

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