Credentialing Specialist

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OCHIN, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2000

🤝 Non-profit

☁️ SaaS

🤝 B2B

Non-profit • SaaS • B2B

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

• Perform all aspects of the credentialing, privileging, and payor enrollment processes for providers under the OCHIN Collaborative or contracted third parties. • Manage credentialing applications and verify credentials. • Maintain provider files internally and externally with payor plans. • Timely processing of initial credentialing and recredentialing applications in accordance with regulatory requirements. • Reviewing and analyzing credentialing applications and supporting documents for accuracy and completeness. • Validating and verifying provider credentials through the appropriate verification sources. • Identifying discrepancies in information and conducting research and follow-up.

🎯 Requirements

• Minimum of three (3) years of progressive experience in Credentialing and/or Provider Enrollment, 5+ years preferred. • In-depth knowledge of credentialing, privileging and provider enrollment standards (HRSA, FTCA, TJC, NCQA, etc.) preferred. • Experience in MD-Staff preferred. • Certified Provider Credentialing Specialist (CPCS) may be required or strongly preferred. • Proficiency in credentialing software and data management systems is 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 the ability to build strong relationships and communicate effectively with diverse stakeholders preferred. • Familiarity with Jira for issue tracking and task management preferred.

🏖️ Benefits

• Generous compensation package • Healthy work-life balance • Professional advancement opportunities • COVID-19 vaccination requirement