Credentialing Specialist

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    "requisitionDescription": "<div><div><div><p style=\"margin-left:0in;\" data-pasted=\"true\"><strong>Position Summary:</strong></p><p style=\"margin-left:0in;\">The Credentialing Specialist is responsible for supporting the end-to-end credentialing and recredentialing process for providers across multiple TINs and brands. This role ensures accurate, timely payer enrollment and maintenance of provider records while serving as a key administrative partner to the Senior Credentialing Specialist. The position plays a critical role in minimizing revenue delays and maintaining compliance with payer and regulatory requirements.</p><p style=\"margin-left:0in;\"><strong>Key Responsibilities:</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;\"><li style=\"margin-left:0in;\">Manage initial credentialing and recredentialing for providers with commercial and government payers</li><li style=\"margin-left:0in;\">Prepare and submit credentialing applications, ensuring completeness and accuracy</li><li style=\"margin-left:0in;\">Track application status and proactively follow up with payers to ensure timely processing</li><li style=\"margin-left:0in;\">Maintain provider records in credentialing systems and databases</li><li style=\"margin-left:0in;\">Monitor and manage expirables (licenses, certifications, malpractice insurance, etc.)</li><li style=\"margin-left:0in;\">Assist with payer roster submissions and directory updates</li><li style=\"margin-left:0in;\">Support enrollment for new providers, new locations, and additional TINs</li><li style=\"margin-left:0in;\">Serve as a liaison between internal departments (RCM, operations, compliance) and external payers</li><li style=\"margin-left:0in;\">Provide administrative support to the Senior Credentialing Specialist, including documentation management and reporting</li><li style=\"margin-left:0in;\">Identify and escalate issues that may impact provider enrollment or revenue cycle performance</li><li style=\"margin-left:0in;\">Contribute to process improvements and standardization efforts</li></ul></div><p style=\"margin-left:0in;\"><strong>Qualifications:</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;\"><li style=\"margin-left:0in;\">2+ years of credentialing or payer enrollment experience in a healthcare setting</li><li style=\"margin-left:0in;\">Knowledge of commercial and government payer credentialing requirements</li><li style=\"margin-left:0in;\">Experience working with multiple TINs and provider groups preferred</li><li style=\"margin-left:0in;\">Familiarity with credentialing systems (e.g., CAQH, PECOS, or similar platforms)</li><li style=\"margin-left:0in;\">Strong organizational skills and attention to detail</li><li style=\"margin-left:0in;\">Ability to manage multiple priorities and meet deadlines</li><li style=\"margin-left:0in;\">Effective communication and follow-up skills</li></ul></div><p style=\"margin-left:0in;\"><strong>Skills &amp; Abilities:</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;\"><li style=\"margin-left:0in;\">Detail-oriented and process-driven</li><li style=\"margin-left:0in;\">Strong problem-solving skills</li><li style=\"margin-left:0in;\">Ability to work independently and collaboratively</li><li style=\"margin-left:0in;\">Proactive and accountable</li><li style=\"margin-left:0in;\">Adaptable in a fast-paced, growing environment</li></ul></div><br>This is a <strong data-start=\"691\" data-end=\"706\" data-pasted=\"true\">hybrid role</strong> based in Riverside, CA. Onsite presence is required on a regular basis, with flexibility to work remotely based on business needs.</div></div></div>\n<br/>Mon - Fri (hours based on business needs)",
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