Credentialing Specialist

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Sailor Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

⚕️ Healthcare Insurance

📡 Telecommunications

Healthcare Insurance • Healthcare • Telecommunications

Sailor Health is a mental health service dedicated to providing compassionate therapy specifically designed for seniors. They connect older adults with experienced therapists who specialize in geriatric care, offering personalized therapy sessions online or over the phone, with most being covered by Medicare. Sailor Health emphasizes accessibility and affordability, ensuring that seniors can receive the support they need from the comfort of their homes.

📋 Description

• Manage provider enrollment & credentialing: Lead the full credentialing lifecycle for new and existing providers and practice locations — including Medicare (PECOS), Medicare Advantage plans, and other payers. • Maintain provider data: Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information. • Optimize workflows: Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices. • Develop SOPs: Write, maintain, and iterate standard operating procedures for credentialing functions and integrate them into operational practice. • Monitor compliance: Track credentialing status, re-credentialing deadlines, notices, and plan requirements to ensure uninterrupted provider participation in payer networks. • Communicate across teams: Partner with internal stakeholders — including Clinical Operations, Payer Strategy, and Provider Growth — to align priorities and share updates on credentialing progress and blockers. • Provider support: Serve as a credentialing point of contact for providers and internal teams, answering questions and coordinating documentation submissions.

🎯 Requirements

• 3+ years of direct experience in provider enrollment and credentialing, including both group and individual provider enrollments. • Extensive experience working with PECOS enrollments, I&A, and request for corrections – this is a must. • Prior work with Medicare Advantage health plans and credentialing requirements. • Comfortable learning and using tools such as Airtable, credentialing automation software, and common office/productivity apps. • Impeccable attention to detail, stay organized, and meet deadlines in a fast-paced environment. • Experience building SOPs and improving operational workflows. • Able to work cross-functionally and communicate clearly with internal teams and external partners.

🏖️ Benefits

• Competitive salary • Comprehensive benefits, including medical insurance • Flexible PTO and sick days • Friendliest and most dynamic team culture