Healthcare Credentialing Specialist

We will ONLY consider applicants who meet the requirements below. If you do not meet these requirements, please do not apply.

We a US-TX based company that builds software and provides related services to healthcare organizations that support their staff credentialing and learning needs.

We are seeking someone with a minimum of 2 years experience in US-based medical staff insurance credentialing/enrollement. This position is for 20 to 30 hours per week. Because we are based in the US, we will expect the right candidate to be available for 3-5 hours each week Monday – Friday, 8am to 6pm US Chicago/Central Time. The bulk of your working hours can be flexible and more appropriate to PhST time.

In addition to the list of responsibilities and daily tasks listed below, the ideal candidate will also:
* be comfortable using web-based business software (ie MS Word, Outlook/GMAIL, Excel, Google Docs, Google Sheets, etc)
* have strong written and spoken English communication skills
* have a reliable computer and internet connection
* have the self-discipline and focus to work remotely and independently to meet deadlines

The following are the typical responsibilities and daily tasks you’ll be accountable for:
* Maintain provider enrollment information within the credentialing database and pulls reports for hospital administration, marketing, professional billing staff, and clinic directors/managers as needed.
* Evaluate credentialing/privileging requests and evidence of education, training, and experience to determine eligibility for requested privileges, membership, and/or plan participation.
* Compile, evaluate, and present the practitioner-specific data collected for review by one or more.
* Recognize, investigate, and validate discrepancies and adverse information obtained.
* Participate in surveys and audits of regulatory and accreditation agencies or organizations.
* Obtain and evaluate practitioner sanctions, complaints, and adverse data to ensure compliance.
* Verify and document expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
* Work with the different insurance companies and our team to stay informed of updates, changes and important requirements

The salary is negotiable and dependent on your experience. We pay weekly using Payoneer. In addition to the salary, we also offer a benefits package to cover health insurance cards and paid time off for our part time and full time team members.

Interested candidates should respond to this job posting with a current resume, confirmation that you are available to meet during US business hours as stated above for a few hours each week. Also include any certifications or formal training you have earned related to credentialing, (ie CPCS®, CPMSM®) and/or medical services/staffing. Also make sure we have the best email to reach out to you should you be selected to interview.

Candidates who meet our requirements will be contacted for an interview within the next week. You should be available to begin working within a few days to a week of being hired.