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Credentialing Specialist

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Extensive experience in healthcare and provider credentialing and enrollment., Knowledge of payer enrollment processes, CAQH, NPPES, PECOS, and insurance verification., Strong attention to detail and organizational skills., Excellent communication skills and proficiency in Microsoft Office and credentialing software..

Key responsabilities:

  • Manage and drive the credentialing and re-credentialing of healthcare providers with health plans.
  • Prepare, review, and submit enrollment applications and supporting documentation.
  • Track and follow up on application statuses to ensure timely approval.
  • Communicate with insurance companies and the internal team to resolve credentialing and enrollment issues.

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Red Cell Partners Startup https://redcellpartners.com/
11 - 50 Employees
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Job description

About Us

Red Cell Partners is an incubation firm building and investing in rapidly scalable technology-led companies that are bringing revolutionary advancements to market in three distinct practice areas: healthcare, cyber, and national security. United by a shared sense of duty and deep belief in the power of innovation, Red Cell is developing powerful tools and solutions to address our Nation’s most pressing problems. 

Location: Remote 

Reports to: VP Strategy & Operations 

Work Schedule: Part-time 

Company Overview: 

Savoy Life is a healthcare startup focused on improving senior living. Savoy Life’s model of care aims to support senior living communities and help tie residents, their caregivers, and the providers within the community together. This is done by partnering with senior living communities to coordinate and manage clinical gaps for residents to improve these facilities’ core business drivers. We deploy our own team of clinical experts both in-person and virtually paired with technology to provide instant leverage and relief for the facilities’ staff and fill gaps in care not always met by existing providers in the community. We honor residents’ existing care team including primary care via wraparound services to give residents the high-quality care and support they deserve, on their terms. 

Job Overview: 

Savoy Life is seeking detail-oriented part-time credentialing support health plan enrollments around the country. This is a fully virtual role that will largely work independently to identify processes and contacts to enable health plan enrollment for our medical group. Additionally, this role is responsible for credentialing clinical staff, managing enrollment, and handling other related administrative tasks as needed. 

Key Responsibilities: 

  • Manage and drive the initial credentialing and re-credentialing of healthcare providers with health plans and IPA groups (Medicare, Medicaid, Commercial plans, etc.) including identifying contacts to reach out to when barriers arise
  • Prepare, review, and submit enrollment applications and supporting documentation
  • Track and follow up on application statuses to ensure timely approval
  • Maintain and update provider credentialing files in accordance with regulations
  • Communicate with insurance companies and the internal team to resolve credentialing and enrollment issues  
  • Collect, review, and validate credentials for our clinical team including licenses, certifications, and education
  • Ensure compliance with federal, state, and payer-specific requirements
  • Maintain a credentialing database ensuring all required documents are up to date and complete 

Qualifications: 

  • Extensive experience in healthcare & provider credentialing & enrollment
  • Knowledge of payer enrollment processes, CAQH, NPPES, PECOS, and insurance verification
  • Healthcare billing experience is nice to have
  • Strong attention to detail and organizational skills
  • Ability to act proactively and problem solving focused
  • Excellent communication skills and excel at meet or exceeding deadlines
  • Proficiency in Microsoft Office (Excel, Word, Outlook) and credentialing software 

Compensation: $25-$35/hour. 

We’re an Equal Opportunity Employer: You’ll receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, protected veteran status, or on the basis of disability.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Detail Oriented
  • Microsoft Office
  • Organizational Skills
  • Proactivity
  • Communication
  • Problem Solving

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