Akido
Credentialing Specialist
Chino, CA · Full-time
Sponsorship not specified$24k-$33kDetected 26 days ago
Patient CareCommunicationProblem SolvingCritical Thinking
About the role
- As a Credentialing Specialist, you'll be part of our credentialing/provider enrollment team to ensure providers are credentialed and enrolled quickly and accurately with health plans and hospitals - so patients always have uninterrupted access to care.
- Credentialing/enrollment activities on this team include:
- Filling out provider enrollment applications with health plans, Medicare, Medicaid and hospitals.
Responsibilities
- Work amongst a team of credentialing/enrollment specialists to deliver accurate, timely, and compliant work - including completing credentialing/enrollment tasks.
- Maintain high data quality, including both provider data as well as credentialing data, like expiration dates, contact information, etc.
- Follow SOPs and policies that are designed to streamline workflows and strengthen compliance.
- Maintain compliance with the state, federal, and payer-specific credentialing requirements.
- Act as a liaison for external partners, including payers, hospitals, and credentialing verification organizations.
- Exceptional organization skills, with sharp attention to detail and ability to manage multiple priorities.
Requirements
- 3+ years of experience in provider credentialing.
- Strong knowledge of NCQA standards, payer requirements, and credentialing best practices.
- Excellent problem-solving and critical thinking skills, with the ability to resolve escalated issues.
Nice to have
- Experience with credentialing software and databases (preferred).
Skills
- Maintaining a clean database of provider data and enrollment-related activities in MD Staff.
Compensation
- Hourly pay range
Benefits
- Health benefits include medical, dental and vision
- Life insurance
- Following up with health plans and hospitals on submitted applications.
- Solve complicated credentialing-related issues directly with IPAs and health plans.
- Solve enrollment-related issues as they arise, working directly with health plans to get them resolved.
- Bachelor's degree in healthcare administration, business, or related field (preferred).
Equal opportunity
- equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.
This listing is sourced directly from Akido's careers page and normalized into a canonical job model.