Credentialing Specialist

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $17 - $23 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Upstream Rehabilitation

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

💰 Private Equity Round on 2015-12

Healthcare • Consulting • Healthcare Insurance

Upstream Rehabilitation is the country's largest dedicated provider of outpatient physical and occupational therapy services. Committed to advancing health, Upstream focuses on clinical excellence through post-doctoral educational programs, structured mentorship, and tracking of patient outcomes. The company offers extensive career opportunities in corporate and clinical roles, fostering an inclusive work environment and investing in professional development. Upstream also supports community outreach through its Pillars with Purpose benevolent funds, encouraging associates to engage in volunteer service. With over 1,200 clinics across the United States, Upstream Rehabilitation provides exceptional care and innovative rehabilitation technologies to empower patients on their healing journeys.

📋 Description

• Support initial credentialing and recredentialing of practitioners within the Preferred Therapy Providers network. • Collect and verify practitioner information. • Conduct primary source verification. • Maintain credentialing records, electronic files, and accurate practitioner data in the credentialing database. • Access and manage practitioner information through CAQH and paper application systems. • Provide administrative support for credentialing operations. • Maintain practitioner licensing, credentialing, certification, and insurance records. • Monitor license, certification, insurance, and continuing education requirements, including expiration and renewal dates. • Communicate with internal stakeholders and external practitioners regarding application status, credentialing requirements, and outstanding documentation. • Perform credentialing and recredentialing in accordance with federal and state regulations, payer requirements, accreditation standards, and company policies. • Monitor files and outstanding requirements, escalating delays, deficiencies, or compliance concerns. • Maintain confidentiality, integrity, and security of practitioner information. • Crosstrain and support other functional areas as needed. • Perform other projects and duties as assigned.

🎯 Requirements

• High school diploma or equivalent experience. • Strong attention to detail, self-motivation, and effective written and verbal communication skills. • Demonstrated ability to establish and maintain positive working relationships with providers, leadership, staff, and external partners. • Proficiency in Microsoft Office applications, including Word and Excel, Adobe Acrobat, and web-based systems. • Proven ability to organize and prioritize work, manage multiple responsibilities, and meet deadlines in a fast-paced environment. • Must reside in the United States. • Previous experience with healthcare credentialing, provider enrollment, revenue cycle operations, or other healthcare administrative functions. • Experience supporting healthcare organizations, including physical therapy, rehabilitation, or related clinical settings.

🏖️ Benefits

• Annual paid Charity Day to give back to a cause meaningful to you • 100% employer paid medical health insurance premium option available • Dental and Vision insurance • 401(k) with company match • Generous PTO and paid holidays • Supportive team and leadership invested in your success • Competitive compensation • Comprehensive benefits • Ongoing professional development • Leadership development programs • Ongoing education and professional growth opportunities

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