Credentialing assistant jobs near me - 509 jobs

THIS IS NOT A REMOTE ROLE. YOU MUST RESIDE IN THE COLUMBUS AREA TO BE ON-SITE DAILY The Construction Scheduler will work with the Project Manager to create timetables to manage both time and resources to ensure work is completed on time. Job Duties and Responsibilities: The Scheduler will manage the workload distribution and monitor the customer delivery and job installation progress. The Scheduler will coordinate with Project Management and Leads/Superintendents to create and maintain calendar for project implementation to completion. The Scheduler will identify and anticipate schedule disparities and correct or report to Project Management. The Scheduler will provide to the Project Manager all needed elements to issue Weekly/Monthly Reports The Scheduler performs other responsibilities as assigned. Physical and Mental Requirements: MUST have 2+ years experience with Primavera P6 The Scheduler must be self-motivated, positive in approach, professional and lead others to create, develop and implement project process improvement(s). The Scheduler must promote the Company culture and mission to all employees, vendors, clients and business partners. The Scheduler must have proven problem solving skills, critical thinking skills and the ability to effectively read, write and give oral presentation(s). The Scheduler must have proven high skill level to interpret blueprints and other project documents, including but not limited to, specifications, reporting and quality requirements. The Scheduler must have the ability to learn Company project management systems. Education, Certification, License, and Skill Requirements: Must possess at least a High School diploma or GED equivalency. Must have a working knowledge of Oracle Primavera and Microsoft Project Must have experience in customer interface, such as liaison between the customer and the Company. Must have a minimum of three (3) years of experience scheduling in telecommunications or a related technical or construction field. Must be proficient with Microsoft Office (Word, Excel and MS Project). Must meet Company minimum driving standards. Must be able to manage multiple tasks/projects simultaneously.

**Become a part of our caring community and help us put health first** The Credentialing Professional obtains and reviews documentation to determine status in a health plan. The Credentialing Professional work assignments are often straightforward and of moderate complexity. The Credentialing Professional reviews the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Reviews the information and documentation collected, as well as verification that the information is accurate and complete. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Equal work will be in the Facility Licensing Area. Responsible for assisting with initial, renewal, relocation and termination applications for AHCA, CLIA, Biomedical, HCCE applications. Will assist with Level 2 prints and license and certification verifications and expirables. ****** **Temporary role; 4 month duration is estimated.** **Use your skills to make an impact** **Required Qualifications:** + Associate's degree or related experience + A minimum of two years of credentialing experience in healthcare + Ability to learn credentialing software; ability to complete reporting + Ability to prioritize workload to ensure deadlines are met + Excellent written and oral communication skills required. + Excellent PC skills (including MS Word, Excel and Access) required. **Preferred Qualifications** + Bachelor degree in Business, Health Administration, Accounting or related field required. + Familiar with CAQH + Bilingual; English & Spanish + Experience in managed care or health care administration desired **Additional Information** + **Temporary role; 4 month duration is estimated.** + Remote Role + Standard working hours required; 8:00 am - 5:00 pm; Central or Eastern Time Zones **Work at Home Statement** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $48,900 - $66,200 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. Application Deadline: 01-02-2026 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

Responsibilities: ● Ensure credentialing files are being completed in a timely and accurate manner ● Adhere to internal SLAs ● Complete primary source verifications Education and Board verifications State Licenses ● Reviewing credentialing files and marking them as ready to complete the credentialing process ● Resolve day-to-day questions and blockers for your team and escalate priority issues when needed ● Participate in team meetings alongside other team members to discuss credentialing issues, provide feedback to product and engineering, and discuss process improvement changes ● Communicating with providers through the credentialing process, assigning out tasks and following up on outstanding tasks We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements 2+ years of provider credentialing experience ● Experience submitting files in accordance with NCQA standards ● Familiarity with state-specific credentialing requirements ● Previous experience working for a CVO (Credentials Verification Organization), completing primary source verification for a high volume of files (25-30+ files per day) ● Experience working in a team environment ● Startup experience ● High attention to detail including effective communications at all organizational levels ● Demonstrated organizational skills and ability to adhere to timelines and SLA metrics ● Expertise in using GSuites tools include GSheets, GDocs, and GMail

About us Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct individualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections and maternal mortality; we improve outcomes and reduce healthcare spend. About us Pomelo Care is a multi-disciplinary team of clinicians, engineers, and problem solvers passionate about improving care for women and children. We are transforming health outcomes by providing evidence-based, compassionate care. For pregnancy and postpartum: We deliver coordinated, virtual care at scale for pregnant people and babies. We support patients throughout pregnancy, NICU stays, and the first postpartum year, measuring our success by reductions in preterm births, NICU admissions, c-sections, and maternal mortality. For perimenopause and menopause: We extend that same personalized model to support women through the midlife transition. We provide expert guidance for symptom management, long-term health planning, and navigating the physical and emotional changes of menopause. Our technology-driven care platform makes this possible, enabling us to deliver the right care at the right time, improving outcomes and reducing healthcare spend across the continuum of women's health. Role Description Your North Star: Work with the New Ventures team to complete health plan credentialing accurately & efficiently. What You'll Do Complete group & practitioner health plan credentialing on behalf of Pomelo's telehealth clinic & care team. Track applications from submission to approval, contracting, and agreement, ensuring cross-functional visibility into key milestones & timelines. Proactively mitigate application delays & denials; Rigorously follow up on any delays and/or denials to right-size Follow up on any delays and/or denials; Proactively update workflows to Rigorously follow up with Proactively mitigate application delays & denials; Rigorously follow up on delays & denials Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing Collaborates with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications Who You Are 2-4 years of experience in a high volume, credentialing specialist role Deep expertise with commercial health plan credentialing processes, including health plan portals & CAQH Highly organized with a strong attention to detail. A proactive and resourceful problem-solver who is comfortable navigating ambiguity and independently seeks out answers and solutions. An accountable and collaborative team player with excellent communication skills, both written and verbal. An expert at prioritization & time management, who proactively shares deliverable timelines and roadblocks Why you should join our team By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. You'll also learn, grow, be challenged, and have fun with your team while doing it. We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision-making, learning, and always putting the patient first. We also offer: Competitive healthcare benefits Generous equity compensation Unlimited vacation Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship) At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. Our salary ranges are based on paying competitively for our company's size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $55,000 - $75,000 per year. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash. Potential Fraud Warning Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending ******************. If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at ********************** to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.

Are you looking for a role in a company that's solving one of the greatest challenges of our lifetime? Ophelia helps people end their opioid use and restore their quality of life with respect for their time and dignity. Our mission is to make evidence-based treatments for opioid use disorder (OUD) accessible to everyone... and we're looking to bring more people onto our team to help us achieve it. Ophelia is a venture-backed, healthcare startup that helps individuals with OUD by providing FDA-approved medication and clinical care through a telehealth platform. Our approach is discreet, convenient, and affordable. We've been successfully operating in 14 states for almost six years and we're excited to continue our growth. We are a team of physicians, scientists, entrepreneurs, researchers and White House advisors, backed by leading technology and healthcare investors working to re-imagine and re-build OUD treatment in America. The Licensing and Credentialing Specialist helps us achieve our Mission by ensuring our clinicians are properly credentialed, licensed, and enrolled in payor networks to care for our patients. The responsibilities include timely submission of new and renewal licensing requests, credentialing of Ophelia's providers, and the enrollment of Physicians, Nurse Practitioners, and Physician Assistants in managed care organizations and government payors such as Medicare and Medicaid, as well as many commercial plans. The L&C Specialist also maintains accurate provider records within various databases, including CAQH and payer portals. The L&C Specialist works with a team of other specialists and collaborates closely with Clinical Operations, Billing, and Contracting teams to ensure our patient care functions smoothly. The role reports to the Licensing and Credentialing Senior Manager. In this role, you will: Review provider initial and reappointment credentialing applications, ensuring compliance with industry standards. Conduct primary source verification and coordinate the credentialing committee review process Ensure new and renewed license, DEA, and CSR requests are submitted promptly. Follow up directly with providers to gather missing or incomplete information for enrollment submissions. Submit enrollment packets to payers (MCOs, Medicare, Medicaid) in an accurate and timely manner. Monitor enrollment status and address any delays by following up with payers to expedite credentialing approvals. Enter and maintain accurate provider enrollment data in internal and external databases, including CAQH and payer portals, by updating demographic information, practice locations, termination of providers, and other maintenance forms as required. Act as a point of contact between providers, payors, and internal teams to resolve issues related to credentialing, enrollment, and reimbursement. The Ideal candidate will have: Associates degree or equivalent combination of education and experience 3-5 years of working experience in a credentialing and enrollment setting required Knowledge of multi-state/national provider credentialing and/or enrollment required Experience with PECOS/Medicare and or state Medicaid enrollment platforms Knowledge of Google Workplace/Microsoft office or other task management suites National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) certification a plus Our Benefits Include: Remote work anywhere in the United States Competitive medical, vision, and health insurance (many plans are fully covered for the employee!) 20 days of PTO per year 10 company holidays 401k Contribution Platform Additional benefits offered through our benefits provider such as life insurance, short and long term disability, financial wellness, virtual primary care, among others! #LI-Remote Ophelia Compensation Overview We set compensation based on the level and skills required for the role. We value pay transparency and equity, and are committed to fair pay. In order to prevent pay disparities and reduce time spent in negotiations, we take a “first and best” offer approach: this means we're not holding any compensation back from our candidates, and you can feel confident that our pay is fair and does not vary based on the strength of someone's negotiation skills. Compensation is dynamic at Ophelia: as long as the company performs well and meets our targets, there will be opportunities for increased compensation annually. We're happy to discuss this approach and our bands if you have questions during the interview process. Compensation Range $60,000 - $67,000 USD Interested in learning more about Ophelia and this role? Apply to work with us!

Company: Only-Connect Psychological Services Employment Type: 1099 Independent Contractor, Part-Time (20) leading to Full-Time Job Overview: Only-Connect is seeking an experienced and highly organized Credentialing Specialist to manage the full lifecycle of credentialing for our mental health therapists. This role will require credentialing our providers with various insurances and onboarding onto Employee Assistance Program (EAP) platforms, enabling our clients to access vital mental health services. The ideal candidate will be a detail-oriented professional with a strong understanding of the credentialing process in a healthcare setting, particularly within mental health. This is a part-time contract role with the strong potential to grow into a full-time position as our company expands. Key Responsibilities: Insurance Credentialing: Initiate and manage the credentialing process for mental health clinicians with various commercial and government insurance payers (e.g., Aetna, Cigna, BCBS, Optum, UnitedHealthcare, Medicare, Medicaid, etc.). Complete and submit all necessary applications (online and paper), ensuring accuracy and completeness. Track application statuses diligently and follow up regularly with insurance companies to expedite approvals. Maintain accurate and up-to-date provider information in our internal databases and credentialing software. Resolve any issues or discrepancies that arise during the credentialing process. Stay informed of payer-specific requirements and changes in credentialing regulations. EAP Platform Enrollment: Research and onboard our providers to various Employee Assistance Program (EAP) platforms, managing the application and approval process. Ensure all required documentation is submitted for EAP participation. Maintain current knowledge of EAP platform requirements and updates. Administrative & Compliance: Maintain organized digital files and records for all credentialing activities. Assist with the development and implementation of credentialing policies and procedures. Ensure compliance with all relevant federal, state, and payer-specific regulations. Generate reports on credentialing status and timelines as needed. Required Qualifications: Proven experience (2+ years) in healthcare credentialing, specifically with mental health providers Demonstrated experience with insurance paneling (commercial and government payers). Experience with EAP platform enrollment is highly preferred. Strong understanding of CAQH, NPPES, and other relevant credentialing portals and processes. Exceptional attention to detail and accuracy. Excellent organizational and time management skills, with the ability to manage multiple applications simultaneously and meet deadlines. Proactive problem-solver with strong follow-up skills. Excellent verbal and written communication skills. Proficiency with G-Suite, Microsoft Office Suite, and comfortable with learning new software/CRM systems. Ability to work independently and efficiently in a fully remote environment. Reliable internet connection and a dedicated home office setup. Comfortable with building skills to help with session confirmations and various back office administrative tasks Compensation and Benefits: $20-30 hourly rate, commensurate with experience, with clear growth trajectory Part-time position starting at 20 hours/week, building to 30 hours/week Fully remote work environment offering flexibility and work-life balance. 1099 Independent Contract position Opportunity to be part of a supportive and growing team dedicated to improving access to mental healthcare.

Job Description Rezolut Imaging is seeking a Credentialing Specialist to join our team! Who is Rezolut? Rezolut is a national emerging platform of diagnostic medical imaging services. With focus on four key platforms, our vision is to provide topnotch patient care partnered with innovative technology - to achieve better health outcomes. Position Summary The Northeast Credentialing Specialist will be responsible for supporting national payor and facility credentialing support growing Radiology Services Organization. Note: This role will be specifically supporting New York, New Jersey, and Pennsylvania credentialing. As a member of the Payor Contracting and Credentialing team this teammate will be a key contributor to company's objectives by improving our credentialing execution, management and other special projects.The ideal candidate will reside in the New York or California area. Position Duties and Responsibilities Own, track, and manage Medicare, Medicaid, and other third-party public and private payor, facility and provider enrollment and credentialing. Primary point of contact inside and outside of the organization for related questions and requests. Develop and maintain relationships with new and existing third-party payors credentialing counterparts Knowledgeable of credentialing process and best practices as well as staying on top of new trends and respective company impacts. Track, organize and provide timely update for all credentialing applications. Problem solves, troubleshoot and research credentialing issues independently. Partner and support Payor Contracting and Revenue Cycle Management (RCM) departments, patients, etc. with related ad-hoc reporting and analyses as needed. Creation and updating of guides, Standard Operating Procedures (SOPs), announcements, and other documentation for the department and RCM customers. Independently run with ad-hoc projects and other duties as assigned. Required & Desired Professional Skills and Experience Required: at least 2 years of experience in the field or in a related area Required: experience with New York Medicare & Medicaid, NYWC and other 3rd party New York payors Competent in Excel, Powerpoint, Smartsheet, OneNote Nice to have - experience with Credential Stream and Availity Prior Healthcare, RCM, Credentialing, or Medical Billing experience is required Working knowledge and understanding of Medicare physician reimbursement methodologies is required Work collaboratively across multiple functions (Credentialing, RCM, and Payor Contracting) Highly motivated self-starter who is an excellent team player Outstanding organizational and communication (both verbal and written) skills Ability to innovate in a fast-growing work environment and comfortable dealing with ambiguity Ability to work independently in a complex and often fast-paced environment. A self-motivated and resourceful attitude, taking intellectual ownership of work and projects. Proactively identifying issues, prepared to address concerns/questions and make recommendations. What We Offer Immediately accrue PTO as you work! (Full Time) 6 Observed Holidays Medical, Dental, Vision, Life and other voluntary insurances for full-time employees 401(k) Retirement plan Employee Assistance Program Location: Remote

Description & Requirements Maximus is seeking a detail-oriented and organized Credentialing Coordinator to join our team. In this role, you will support the credentialing and recredentialing process for independent contractors, verifying credentials, and maintaining accurate records across multiple databases. The ideal candidate will have strong organization and communication skills, a keen eye for accuracy, and the ability to follow established guidelines while ensuring compliance with health plan requirements. This is an excellent opportunity for someone looking to build experience in healthcare administration and credentialing while contributing to a team that values precision, accountability, and service. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - • Competitive Compensation -Bonuses based on performance included! - • Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. - • Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. - • Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. - • Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). - • Recognition Platform - Acknowledge and appreciate outstanding employee contributions. - • Tuition Reimbursement - Invest in your ongoing education and development. - • Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. - • Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs. - • Professional Development Opportunities-Participate in training programs, workshops, and conferences. - •Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees. Essential Duties and Responsibilities: - Process applications and initial as well as re-credentialing paperwork. - Maintain knowledge of current health plan requirements for credentialing providers including managing delegated health plans. - Complete provider credentialing and recredentialing applications in accordance with guidelines; monitor applications and follow up as needed. - Set up and maintain provider information in online credentialing databases and system. - Collect credentials of incoming providers as per work instructions. - Perform primary source verifications of all practitioner credentials. - Perform data enter into various systems used to credential and recredentiale staff. - Maintain necessary logs, lists, records, and current documentation required for provider credentialing. - Provide regular reports on pending staff and those who have cleared credentialing. Minimum Requirements - High school diploma or GED required and 0-2 years of relevant professional experience required, or equivalent combination of education and experience. - Strong data entry and telephone skills preferred. - Previous experience in claims review or claims auditor preferred. - Previous experience in customer service and call center preferred. -A minimum of two (2) years of Customer Service experience -A minimum of two (2) years of credentialing OR onboarding experience as it relates to new hires (i.e. license verification, background and reference checks, etc). -Strong administrative and organizational skills in a fast-paced environment -Ability to multi-task effectively -Proficiency in MS Office Suite Preferred Requirements -Previous experience with Smartsheet -Previous experience working with Independent Contractors/Staffing Agencies -Previous experience with COUPA -Previous recruiting experience Home Office Requirements -Maximus provides company-issued computer equipment -Reliable high-speed internet service -Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity -Minimum 5 Mpbs upload speeds -Private and secure workspace EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 20.00 Maximum Salary $ 25.00

Sailor Health is on a mission to solve the mental health crisis among older adults. In the United States, older adults have the highest suicide rates of any age group yet receive the least mental health care. By 2030, over 65 million seniors will make up nearly a quarter of the U.S. population, creating one of the largest and most urgent challenges in healthcare. Sailor is building the platform for senior mental health, connecting older adults, therapists, healthcare professionals, and insurance plans. Our AI-native operating system powers seamless care coordination, real-time clinical insights, and insurance billing - enabling therapists to spend more time delivering compassionate care. We are growing quickly and have partnered with Medicare to offer affordable and exceptional psychotherapy to hundreds of patients. ⭐ About the Role Location: Remote - US or Canada based only Title: Credentialing Specialist Salary Range: $40,000 - $55,000 We're hiring a full-time remote Credentialing Specialist to lead and support all aspects of provider credentialing at Sailor Health. You will own end-to-end enrollment of providers and practice locations in Medicare via PECOS, manage credentialing with Medicare Advantage health plans, maintain accurate CAQH profiles, establish SOPs, and improve credentialing workflows. You will also work closely with our leadership team to innovate on our processes and systems. 💻 Your Key Responsibilities Manage provider enrollment & credentialing: Lead the full credentialing lifecycle for new and existing providers and practice locations - including Medicare (PECOS), Medicare Advantage plans, and other payers. Maintain provider data: Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information. Optimize workflows: Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices. Develop SOPs: Write, maintain, and iterate standard operating procedures for credentialing functions and integrate them into operational practice. Monitor compliance: Track credentialing status, re-credentialing deadlines, notices, and plan requirements to ensure uninterrupted provider participation in payer networks. Communicate across teams: Partner with internal stakeholders - including Clinical Operations, Payer Strategy, and Provider Growth - to align priorities and share updates on credentialing progress and blockers. Provider support: Serve as a credentialing point of contact for providers and internal teams, answering questions and coordinating documentation submissions. ✅ What We're Looking For Credentialing experience: 3+ years of direct experience in provider enrollment and credentialing, including both group and individual provider enrollments. PECOS wizard: You have extensive experience working with PECOS enrollments, I&A, and request for corrections - this is a must. Medicare Advantage applications: Prior work with Medicare Advantage health plans and credentialing requirements. Tracking and project management tools: Comfortable learning and using tools such as Airtable, credentialing automation software, and common office/productivity apps. Detail-oriented & organized: You have impeccable attention to detail, stay organized, and meet deadlines in a fast-paced environment. Process mindset: Experience building SOPs and improving operational workflows. Collaborative communicator: Able to work cross-functionally and communicate clearly with internal teams and external partners. ⛵ Why Sailor Health? Mission with impact. Help bring life-changing care to a population that's too often overlooked. Remote-first team. Enjoy the flexibility of remote work while staying closely connected with a thoughtful, collaborative team rooted in purpose. Growth and ownership. Be part of a small, agile team where you'll take initiative, shape key processes, and grow as we grow. Make someone's day - every day. Your work helps older adults and their families feel seen, supported, and cared for. Our Offer to You 💰 Competitive salary 🩺 Comprehensive benefits, including medical insurance 🌴 Flexible PTO and sick days 🕺🏻 Friendliest and most dynamic team culture If this sounds like you, we'd love to connect. Join us in redefining what it means to age with dignity, connection, and mental wellness.

About the Company: Octave is a modern behavioral health practice creating a new standard for care delivery that's both high-quality and accessible. With in-person and virtual clinics in multiple states, the company offers evidence-based individual, couples, and family therapy, while pioneering relationships with payers to make care more affordable through insurance. By raising the bar on how care is delivered and how providers are supported, we are building a sustainable system that values equity, affordability, and effectiveness. About the Role: As an Octave Credentialing Coordinator, you will play a vital role in ensuring the timely credentialing and renewal of all providers with payors, while effectively meeting the needs of multiple stakeholders including providers, operations, and revenue cycle teams. With a keen attention to detail and a strong desire to establish and maintain efficient systems, you will work towards achieving the company's strategic objectives. Thriving in a fast-paced, high-growth environment, you will embrace the inherent variability and opportunities it offers, demonstrating initiative and problem-solving skills. This position reports to the Credentialing Manager and is fully remote currently. Responsibilities Include: Collaborate with providers to ensure completion of enrollment applications and track the progress across various payor portals. Perform primary source verifications during initial and re-credentialing cycles. Establish and cultivate relationships with internal and external stakeholder groups. Interact with health plans as needed to ensure accurate provider data is present. Regularly review and validate provider rosters across various payor partnerships. Ensure all internal systems are kept up to date with the most recent provider information Support documentation of processes and procedures. Ensures information is complete, accurate, clear, and concise by following process steps outlined in standard operating procedures. Performs follow-up to ensure quality of work and/or actions are completed. Preferred Qualifications: 1+ year experience in credentialing, with 3 years of experience in a healthcare setting preferred. Experience using various portals and systems, like CAQH, Availity and Salesforce. Proficiency in Gsuite, MS office and excel. Strong prioritization skills. Follows a particular set of instructions given by management or outlined in standard operating procedures. Comfortable in an ambiguous, fast paced environment where all processes might not be fully fleshed out. Effective and empathetic communicator who knows ones audience and can tailor messaging as needed. Calm and clear in conflict resolution with skill in de-escalation when needed. Understands the customer and takes a proactive approach to meeting their needs in an effective and timely manner. Completes individual objectives that contribute to the department and organizations goals. Be a lifelong learner, curious and kind striving towards continuous improvement. Octave's Company Values: The below values drive our day-to-day operations. We're human beings first. We operate with empathy and kindness - with our clients, with our collaborators, and with ourselves. People deserve better than status quo. We're willing to tackle the intractable problems, no matter how big, because someone should. We ask big questions, we craft big solutions, and we challenge ourselves and others to make it happen. No bystanders. No stars. No tourists. Each person has been selected to be here, and with that comes a responsibility to bring your expertise, share your ideas, and help make this company better. Partnership paves the path ahead. We don't operate in a silo, internally or externally. To transform the system, we believe in working with others to create something bigger, better, and stronger. Quality is crucial at scale. Quality is core to our business, and we refuse to sacrifice it as we grow. Progress is a process. In the pursuit of progress, we iterate, reflect, learn, adjust - and always leave things better than we found them. There are people behind every data point. We recognize that numbers tell only one part of the story, and we also do the work to understand impacts at the individual level. Physical Requirements: Available to work 8am to 5pm or 9am to 6pm MST or PST. Prolonged periods sitting at a desk and working on a computer. Must be able to frequently communicate with others through virtual meeting applications such as Zoom and Google Meet. Must be able to observe and communicate information on company provided laptop. Move up to 10 pounds on occasion. Must be eligible to work in the United States without sponsorship now or in the future. Compensation: Octave is committed to pay equity. To maintain our commitment to pay equity, Octave will follow Pay Transparency regulations on all open job postings. Current Pay Transparency laws require companies to include a position's salary or hourly wage range (not including bonuses or equity-based compensation) in any internal or external job posting. This requirement extends to job postings published by a third party at an employer's request. Octave will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Octave's legal duty to furnish information. Starting pay for qualified applicants will depend on a combination of job-related factors, which may include education, training, experience, location, business needs, or market demands. The expected salary range for this role is set forth below and this range may be modified in the future. The salary range for Geo 1 (all states, excluding those in Geo 2 or Geo 3, and D.C.) is $23.51 - $25.00 per hour. The salary range for Geo 2 (CO, HI, MD, RI) is $25.87 - $27.50 per hour. The salary range for Geo 3 (AK, CA, CT, MA, NJ, NY, WA) is $27.02 - $28.75 per hour. Additionally, this position is eligible for the following benefits: company sponsored life insurance, disability and AD&D plans. Voluntary benefits such as 401k retirement, medical, dental, vision, FSA, HSA, dependent care and commuter/parking options are also available. Octave offers generous Paid Time Off as well as paid parental leave benefits. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Application Instructions: Please complete the following application. Please note that the U.S. Equal Opportunity Employment Information questions below are used for the purposes of EEOC reporting and are optional to complete. Octave is unable to change these questions and we acknowledge that many of the U.S. Equal Opportunity Employment Information questions are not inclusive or affirming of all aspects of cultural identity. Octave is committed to an inclusive workplace environment, and this information will not inform how we approach hiring or employment.

operates on an Eastern time zone schedule. Responsible for performing all tasks related to the credentialing, filing, updates and follow up for CPa Medical Billing. Job Type: Full-time Pay: $19.00 - $25.00 per hour Benefits: 401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Life insurance Paid time off Referral program Vision insurance Schedule: Monday to Friday Work Location: Remote Responsibilities ESSENTIAL FUNCTIONS & RESPONSBILITIES Complete credentialing and/or re-credentialing applications for physicians and ancillary providers with third-party payers and governmental programs (Medicare and Medicaid) as requested by the client in an accurate and timely manner Complete, update and maintain Council for Affordable Quality Healthcare (CAQH) profiles for providers Ensure credentialing data needed for enrollment, contracting, and other related purposes is on file. Maintain provider credentialing files electronically Maintain credentialing software with current information Reach out to insurance carriers regarding any outstanding items/applications Resolve issues related to provider participation Respond to various inquiries from participating physicians, staff, hospitals, and managed care companies timely and with professionalism Maintain a strict level of confidentiality for all matters pertaining to provider credentials Communicate client/enrollment issues to management at an early stage Must be able to work on various projects as assigned by Credentialing Manager Other duties as assigned Qualifications EDUCATION: High school diploma or GED equivalent EXPERIENCE: Three to Five years of relevant healthcare experience is required including specialized skills in Credentialing. Experience with Windows applications, proficient use of computer, Microsoft Word, Outlook and Microsoft Excel. Strong communication, verbal and written and interpersonal skills. Ability to analyze and solve problems with limited assistance. LANGUAGE SKILLS: Knowledge and use of the English language, Bi-lingual a Plus MATHEMATICAL SKILLS: Basic math skills REASONING ABILITY: Critical thinking, analytical and problem-solving skills A successful candidate will have the following: Outstanding customer service, interpersonal and written skills. The ability to work independently, as well as, in a team setting Exceptional organization and time management skills to manage priorities and deadlines Strong attention to detail and quality Proficiency with Microsoft Office Suite (Word,Outlook); Excel preferred

HOURS: 40 hours/week, Dayshift JOB TYPE: Contractor (1099) REPORTS TO: Manager, Medical Staff, Avel eCare The Licensing and Credentialing Specialist is responsible for gathering and maintaining information needed for licensing, credentialing, and re-credentialing of all Avel eCare providers, distributing information to the appropriate sites/agencies, preparing summaries and reports as requested, and maintaining the provider database and highly confidential personnel files. ESSENTIAL FUNCTIONS: 1. Responsible to work independently in obtaining and supporting licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes of all Avel eCare practitioners, including but not limited to physicians (MD and DO) and non-physician practitioners (CNP and PA), registered nurses, respiratory therapists, social workers, and pharmacists. Reprioritizes work as necessary to meet deadlines. 2. Maintains a working knowledge of and independently ensures compliance with applicable policies and procedures, The Joint Commission standards, Centers for Medicare and Medicaid Services (CMS) standards, and applicable federal and state laws; and applies them to the licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging process. 3. Maintains a comprehensive electronic and hard copy filing system. Collects and distributes appropriate information regarding each Avel eCare clinical nurse and medical practitioner (with practitioners' assistance, as appropriate) in an accurate and timely manner without deficiency and in a cost-effective manner. Ensures the accuracy and integrity of electronic tools used for tracking and follow up regarding the licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes. Generates Avel eCare practitioner specific reporting including, but not limited to state licensure and hospital affiliation. 4. Establishes and maintains effective working relationships with practitioners, practitioner affiliated clinic managers, Avel eCare customers, state licensure representatives, various Medical Support Services offices, Credentialing and Verification Service, other departments, and other applicable resources. Ensures good communication with all entities to maintain accurate information and alerts upper management of potential issues affecting stakeholder relationships. 5. Provides status information to appropriate stakeholders of nursing or medical licensure/re-licensure, credentialing/re-credentialing, medical staff appointment/re-appointment, and privileging/re-privileging processes in a timely and professional manner. 6. Performs generalized secretarial duties in an accurate and timely manner to include, but not limited to transposes handwritten or verbal communication to a typed format, edits all typing for typos and corrects as necessary, makes copies of products as requested, collates, assembles, and distributes information as directed. Processes mail, faxes, and other types of communications. 7. Maintains competencies in using software programs including credentialing platforms Internet Explorer, Microsoft Outlook and Microsoft Office Products, and Adobe Acrobat, etc. 8. Organizes and executes special projects and other duties as assigned by Avel eCare Credentialing Manager. REQUIRED EDUCATION and/or EXPERIENCE: One year credentialing experience preferably in Telemedicine. CPCS Certification preferred. JOB CODE: 481

Clarity RCM is the nation's leading revenue cycle platform for dermatology, partnering with independent practices in over 40 states to improve financial performance, streamline operations, and deliver exceptional patient experiences. We are a profitable, fast-growing company with a fully remote U.S. team and a large in-office operation in India. The Role US-Based Candidates only. International applicants will not be considered. We are seeking a highly organized, detail-oriented, and execution-focused Credentialing Specialist who will own provider enrollment, credentialing workflows, and payer setup for dermatology practices nationwide. This is a critical role that requires someone who can make sense of complex, disparate information and turn it into clear, repeatable processes. The ideal candidate thrives in environments that need more structure. You enjoy bringing order to moving parts, synthesizing information from many sources, and building systems where none exist. You take pride in creating workflows, organizing information, documenting steps, and establishing processes that allow the credentialing function to scale. You should be comfortable with complex requirements, persistent follow-up, and maintaining accurate, audit-ready documentation at all times. You are tech savvy, proactive, and committed to delivering clean, reliable work that enables providers to practice without interruption. What You Will Do Credentialing and Provider Onboarding Own the full lifecycle of credentialing for physicians and advanced practice providers, including initial onboarding, primary source verification, re-credentialing, and ongoing monitoring. Verify education, training, licenses, board certifications, malpractice insurance, and work history with complete accuracy. Ensure all credentialing files meet NCQA, TJC, CMS, and payer-specific requirements. Payer Enrollment and Maintenance Prepare, submit, and track enrollment applications with commercial payers including BCBS, UHC, Aetna, and Cigna, as well as Medicare and Medicaid. Manage CAQH ProView including quarterly attestations and document maintenance. Process Medicare enrollments and updates through PECOS. Verify that providers are correctly linked to group tax IDs to prevent out-of-network billing issues. Track effective dates and panel statuses and communicate updates to internal stakeholders. Process Building and Workflow Design Create structure in areas that currently have few or inconsistent processes. Organize credentialing inputs from multiple sources and turn them into clear workflows, trackers, and checklists. Identify bottlenecks, design solutions, and implement improvements that enhance accuracy, speed, and consistency. Document processes and maintain updated SOPs that support ongoing team alignment and scale. Cross-Functional Collaboration Work closely with internal teams to keep credentialing and enrollment workflows moving. Support account managers, operations, and revenue cycle teams by providing accurate status updates and resolving credentialing-related blockers. Partner with billing and AR teams to investigate and resolve claim denials caused by credentialing or enrollment issues. Data Management and Documentation Maintain accurate provider data across CAQH, PECOS, payer portals, and internal systems. Own a master tracker that includes effective dates, expirables, re-credentialing deadlines, panel statuses, and outstanding items. Keep all credentialing records continuously audit-ready with complete and up-to-date documentation. Licensing Support Monitor expiring state licenses, DEA registrations, malpractice insurance, and board certifications. Communicate proactively with providers to ensure renewals are completed well before expiration dates. What You Will Bring Experience: 2 to 3 years of hands-on medical credentialing or payer enrollment experience. Technical Knowledge: Familiarity with CAQH, PECOS, payer portals, and credentialing software. Strong understanding of NCQA, TJC, CMS, and standard credentialing requirements. Structure Building: A track record of bringing order to complex or unstructured environments and building processes that scale. Attention to Detail: Ability to identify inconsistencies instantly and maintain clean, accurate files. Follow-Through: Persistent and professional when gathering documentation or resolving gaps. Communication: Clear, concise, and confident written and verbal communication skills. Technology Mindset: Comfortable navigating multiple systems and adopting new tools. Judgment: Ability to handle PHI and sensitive information with complete discretion. Mindset: Process-driven, organized, proactive, resourceful, and committed to continuous improvement. Additional Details Location: Fully remote role based in the United States. Compensation: Competitive salary with benefits, commensurate with experience. Why Join Clarity RCM At Clarity, you will join a mission-driven, founder-led organization transforming how independent dermatology practices operate. You will help build a credentialing function known for accuracy, speed, and reliability, and you will be part of a culture that values operational excellence, collaboration, and continuous improvement.

Unless otherwise noted, all positions are fully remote with work permitted from the following states: CA, CO, IL, MA, MD, NJ, NY, OR, and WA. We are living through a pivotal moment for reproductive and sexual health-and Hey Jane is uniquely positioned to help. From day one, we've been committed to providing safe, discreet medication abortion treatment-and have helped more than 100,000 people get the care they need. Today, we offer a range of reproductive and sexual health care services from the comfort and convenience of your phone. Our in-house clinical care team, composed of board certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away. We're committed to helping our patients get safe, discreet, judgment-free virtual health care, from a team that truly cares. Role OverviewWe are seeking a highly organized and detail-oriented Licensing & Credentialing Specialist who thrives in dynamic environments and is motivated by the opportunity to help clinicians deliver high-quality, patient-centered care. In this role, you will manage all aspects of provider licensing, credentialing, and payer enrollment, ensuring our clinical team remains fully compliant, up-to-date, and able to practice without interruption. You will coordinate end-to-end licensing workflows, maintain accurate records across multiple systems, and act as a key liaison between clinicians, state boards, payers, and internal stakeholders. The ideal candidate is comfortable working in the details, managing many moving pieces, and being persistent in communications. You excel at spotting gaps, creating structure where it's needed, and keeping processes running smoothly to help our clinicians care for patients without administrative delays. Why this role matters This isn't your average administrative role: the systems you maintain and improve directly determine how quickly and effectively patients can access safe, timely, and compassionate care. In a moment where access to care is more important than ever, your work will have a tangible impact on clinicians' ability to practice and on the future of accessible healthcare across the U.S.At Hey Jane, we work towards the vision of having equitable healthcare, changing the status quo, and rebuilding the way people experience healthcare-and bring that same vision to our workplace. We're an equal opportunity employer committed to building an inclusive environment, and encourage all applicants from every background and life experience.

AVAILABLE Medical Billing & Credentialing Specialist Reports to: Director of Finance January 12, 2026 Position Type: Full-time, Bargaining Starting Salary: $37,599 annually Hours: Mon. - Fri., 8:30 a.m. to 4:30 p.m. Vaccine Policy: All new hires will need to meet vaccination requirements or request an exemption and submit a TB Baseline as outlined in the CCBH Vaccination Policy. Minimum Requirements: Associate's degree in health information management technology or related field or two years of direct experience. Minimum of three years of medical office and medical billing with collection experience. OR five years of experience (with HS Diploma/GED), OR one year of experience (with Bachelor's degree), OR no experience necessary (with Master's degree). Certified Medical Coder and Certified Medical Insurance Specialist credentials. Ability to efficiently multi-task on a daily basis. Strong knowledge of medical terminology, billing/collection processes, and insurance billing and coding (ICD-10 and CPT). Knowledge of local, state, and federal billing regulations and third-party insurance program requirements. Proficiency with use of databases for data querying and reporting. Proficiency with use of PC hardware & basic software (i.e., Microsoft office), email, and office equipment (i.e., copier, fax, scanner, telephone, etc.). Strong customer service, verbal and written communication skills, and organizational skills. Good interpersonal relationship skills including cultural sensitivity & competence. Responsibilities: Maintains up to date knowledge of third-party billing procedures and regulations in accordance with HIPAA, CMS, the ACA, etc. Leads the claims resolution process on behalf of the agency with third party providers. Provides assistance with the development, implementation and/or revision of policies/procedures governing CCBH's medical billing process. Revises, corrects, and codes medical charges into the billing system. Enters/updates medical charges into billing system. Addresses and resolves billing discrepancies with third party providers. · Verifies insurance eligibility and level of benefit coverage for clients. Reviews all medical claims for accuracy prior to submission to the medical claims clearinghouse for payment processing. Collaborates with third party providers to resolve claims issues on agency's behalf. · Assists with the updating and maintenance of the clinic fee schedule utilizing the CPT, HCPCS, and ICD-10 code databases. Maintains up to date knowledge of the latest methods of data collection, coding, billing, collection, and claims submission. Serves as a resource to clinic staff related to the medical coding/billing process. Receives and posts daily revenue from insurance carriers and direct client payments into the billing system and reviews and remedies any denials. Confers with the insurance carrier and/or clinic staff to resolve any discrepancies. Generates invoices to clients for balances owed. Performs periodic reviews of CCBH contracts and agreements to ensure availability of the most current information for all medical insurance carriers, CCBH, and its providers. Consults with CCBH General Counsel for contract approvals and collaborate with the relevant clinic supervisory staff. Completes/updates provider enrollment credentialing and credentialing process. Maintains timely and accurate entry of provider data in CAQH and all other required databases. Monitors expiring licensure, board and professional certifications, and other documents that expire for all providers and ensure timely renewals. Collaborates with internal and external partners on special projects as assigned. Participates on internal and external subcommittees. Develops and extracts reports from databases (i.e., EHR, etc.) for delivery to internal and external customers. Creates and runs regular reports for collections, billing, program statistics, etc. Gathers and organizes documents to satisfy client record audits or other reporting obligations. Participates in public health emergency activities as needed. May be required to operate agency-owned fleet vehicles at offsite service locations. Performs other duties as assigned. Please complete the online application on our website, ***************** All applicants are required to upload a resume and include a cover letter with their application. Deadline to Apply: Posted Until Filled Bilingual Applicants Welcome Benefits offered at CCBH (for employees working at least 40 hours per pay period/Bi-weekly): Medical (full time employees responsible for 10% of premium) Dental (full time employees responsible for 10% of premium) Vision Public Employee Retirement System (PERS) Deferred Compensation FSA Health and Dependent Care Tuition Reimbursement Holidays (14 paid per year) Vacation Time (13 paid days per year for new service PERS members*) Sick Time (15 paid days per year*) Personal Days (up to 3 paid per year) Agency paid Life Insurance Additional Voluntary Life Insurance Voluntary Identity Theft Protection Voluntary Critical Illness Voluntary Accident Insurance Employee Assistance Program Free Parking Onsite Remote work from home available up to two days per week with approval after the completion of a minimum of 60 days of employment. Alternate work schedule or changes in work schedule available after initial training period with approval. Core work hours of 10am to 2pm required of all staff. *Benefit is prorated based on start date Employees hired for a position that is funded in whole or in part by a designated funding source may be laid off when the funding source is reduced or eliminated. THIS AGENCY IS AN EQUAL PROVIDER OF SERVICES AND AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER CIVIL RIGHTS ACT 1964 THIS EMPLOYER PARTICIPATES IN E-VERIFY All employees hired for a position must be legally authorized to work in the United States without requiring sponsorship for employment visa status now or in the future.

Under the direction of the Credentialing Manager, the Credentialing Coordinator is responsible for coordinating all aspects of the credentialing and/or recredentialing process as well as changes in privileges/specialty or demographic information for health care professionals practicing within CommUnityCare health centers. This position ensures health care professionals are appropriately credentialed and privileged, including ongoing maintenance and verification of current information on file and within the credentialing database, and other duties required to maintain compliance with regulatory and accreditation agencies and CommUnityCare credentialing policies and procedures. Responsibilities Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):• Reviews, screens, and completes initial credentialing and/or recredentialing, and additional privilege request applications for completeness, accuracy, and compliance with federal, state, local, and CommUnityCare regulations, standards, policies, and guidelines. • Perform and collect primary source verification (PSV) of all credentialing elements and validates the information to ensure accuracy. • Data entry of new applications in the credentialing database.• Communicates clearly with providers, their credentialing representative, and leadership as needed to provide timely updates and responses on day-to-day credentialing and privileging issues as they arise. • Analyzes, identifies, resolves discrepancies, time gaps, and other issues that could impact ability to credential healthcare practitioners. • Report issues in a timely manner to Credentialing Manager for decision making in accordance with credentialing and privileging policy and federal state, local, and government and health plans standards. • Provide consistent and timely follow-up on all outstanding credentialing/re-credentialing files.• Process provider demographic changes ensuring appropriate documentation has been submitted with the changes, update credentialing database and notify health plans of changes.• Prepare and scan credentialing/re-credentialing files and other credentialing documentation into electronic folder. • Maintain knowledge of current requirements for credentialing providers.• Ensure all tasks duties comply with all regulatory and accreditation standards including The Joint Commission, the National Committee Quality Assurance (NCQA) guidelines, and CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures.• Responsible for monitoring and managing credentials/recredentialing requirement to ensure the collection of all required renewals are on file within their required time frame. • Responsible for the timely entry, processing, and tracking of credentialing files. Other Job Responsibilities• Ensure all actions, job performance, personal conduct and communications always represent CommUnityCare in a highly professional manner.• Uphold and ensure compliance, confidentiality and adhere to all HIPAA guidelines, and maintain a strict level of confidentiality for all company policies and procedures, departmental, and healthcare provider information as well as the overall mission and values of the organization.• Ensure that all work is done in a timely and accurate manner.• Works within established credentialing timeframes and notifies manager as to status and barriers preventing work being done in a timely and accurate manner.• Maintain strong working relationships with providers, health plan staff, and other credentialing verification offices.• Develop and maintain favorable internal relationships, partnerships with co-workers.• Responsible for the monthly ongoing monitoring of licenses and sanctions.• Audit disciplinary reports, OIG reports, and other reports as required and initiate the formal complaint procedure, when applicable.• Participates in staff meetings and recommends new approaches, policies and procedures to effect continual improvement in efficiency of the department and services performed. • Respond to emails timely and effectively.• Provide support to physicians, physician office staff, and company departments as necessary.• Assist with annual Health Plan delegated credentialing audits. • Cross train within department to support credentialing operations (back-up support for credentialing files, vacation/PTO).• Participate in various educational/training as required.• Perform other job-related duties as assigned. Knowledge/Skills/Abilities:• Articulates knowledge and understanding of organizational policies, procedures, and systems.• Ability to function effectively and work under pressure in a demanding and fast paced environment.• Ability to manage change, delays, or unexpected events appropriately, and demonstrate sense of urgency and strong time management awareness.• Strong organizational, problem solving, and critical thinking skills, and to proactively prioritizes needs and effectively manages resources.• Excellent interpersonal and customer service skills. • Information research skills.• Ability to communicate effectively both orally and in writing.• Ability to use independent judgment and to manage and impart confidential information. • Ability to function effectively in a remote work environment.• Ability to work in both individual or group environment and multitask as needed.• Demonstrate proficiency in Microsoft Word, Excel and Access.• Knowledge of CAQH (Council for Affordable Quality Healthcare) database and application process.• Knowledge of Medicare and Medicaid provider enrollment systems. Qualifications MINIMUM EDUCATION: High School Diploma MINIMUM EXPERIENCE: 2 years of experience in practitioner credentialing with a working knowledge of federal and state regulatory agencies and accrediting bodies (CMS, TJC, NCQA, etc.) PREFERRED EXPERIENCE: 5 years of experience in credentialing and privileging role with knowledge in either an ambulatory, managed care, or hospital credentialing with strong knowledge of federal and state regulatory agencies and accrediting bodies (CMS, TJC, NCQA, etc.) REQUIRED CERTIFICATIONS/LICENSURE: Certified Professional Credentialing Specialist (CPCS) within first 3 years of employment if not already certified upon hire.

The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions. Pay Range: $17.00 - $24.00 based on experience and qualifications Current current work schedules based on EST: 8:30 AM - 5:00 PM 9:00 AM - 5:30 PM 10:00 AM - 6:30 PM 11:30 AM - 8:00 PM Responsibilities Review and process patients' enrollment forms to the Patient Assistance Program (PAP) Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks. Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process Schedule treatments to be sent to the patient or patient's healthcare provider Support inbound and outbound phone lines for the PAP program Communicate daily with patient/authorized representatives on eligibility based on PAP criteria and healthcare providers to manage expectations. Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer's PAP program. Prioritize workload to ensure patients' enrollments are processed within specified timeframe Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician office staff. Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers. Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices. Execute day-to-day operations specific to the assigned program(s). Always maintain patient confidentiality. The above duties are meant to be representative of the position and not all inclusive. Qualifications MINIMUM JOB REQUIREMENTS: High school diploma or equivalent Kentucky Pharmacy Technician Registration Kentucky requires a licensed pharmacy technician to be over the age of 18. Two (2) years of work experience in customer service or customer focused healthcare role One (1) year of work experience in a HUB service or call center environment. Strong attention to detail and accuracy in data entry Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers Must have proven ability to provide consistently high-quality of service PREFERRED EDUCATION AND EXPERIENCE: Education: Associate degree or completion of technical school training in healthcare, pharmacy or a related field Experience: Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field Experience with HIPAA regulations and privacy standards Certifications: National Pharmacy Certification (PTCB, ExCPT) preferred Language Skills: Bilingual proficiency in English and Spanish strongly preferred Prior experience in patient assistance programs and/or benefit verification processes KNOWLEDGE, SKILLS & ABILITIES: Demonstrated empathy and compassion Excellent verbal and written communication skills Excellent organization skills and detail oriented Balance multiple priorities to meet expected response deadlines Adaptable, flexible and readily adjust to changing situations Ability to work independently and as a member of a team Ability to comprehend and apply basic math principles Ability to apply logical thinking when evaluating practical problems Ability to present information and respond to questions from stakeholders Ability to interact with a diverse group Ability to listen and demonstrate a high degree of empathy Demonstrated computer skills includes Microsoft Word, Excel, and Outlook Display tact and diplomacy in response to unfavorable or negative situations Demonstrated sensitivity and understanding when speaking with patients Demonstrated passion for speaking with people in an outgoing way PHYSICAL REQUIREMENTS: Location of job activities Remote, Hybrid or onsite; geographic location Extensive manual dexterity (keyboarding, mouse, phone) Constant use of phone for communication Noise and/or vibrations exposure Frequently reach (overhead), handle, and feel with hands and arms Sit for prolonged periods of time Occasionally stoop, kneel, and crouch Occasionally lift, carry, and move up to 25 pounds Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

(TCT): Total Care Therapy (TCT) is a therapist-owned and operated company specializing in Physical, Occupational, and Speech Therapy services in assisted and independent living settings. Our mission is to empower individuals to regain their independence through compassionate and high-quality care. At TCT, we cultivate a culture that prioritizes flexibility, personal and professional growth, and a collaborative team spirit. Our commitment to fostering a positive and inclusive culture ensures that every member of our team feels valued and motivated to make a meaningful impact on the lives of those we serve. Position Summary The Insurance Credentialing Specialist is responsible for managing and maintaining the credentialing and re-credentialing process for healthcare providers with insurance payers, government programs, and regulatory bodies. This role ensures that all providers meet compliance requirements and are enrolled accurately and efficiently to support timely reimbursement and uninterrupted patient care. Key Responsibilities Complete and submit initial credentialing, re-credentialing, and enrollment applications to insurance companies, Medicare/Medicaid, and other payer systems. Maintain up-to-date provider files, including licenses, certifications, malpractice insurance, CAQH profiles, and other required documentation. Monitor expirables and ensure timely updates to prevent lapses in participation or reimbursement. Track application status, follow up with payers, and resolve delays or discrepancies. Serve as a liaison between providers, practice administrators, billing staff, and insurance representatives. Verify provider credentials and ensure compliance with payer and regulatory requirements. Manage database entries and maintain accurate electronic records. Assist with audits, compliance reviews, and reporting as needed. Communicate changes in payer policies or credentialing requirements to leadership and staff. Support the onboarding process by ensuring new providers are enrolled with all necessary payers in alignment with start dates. Qualifications High school diploma required; associate or bachelor's degree preferred. Prior experience in credentialing, medical billing, or healthcare administration strongly preferred. Knowledge of CAQH, NPPES, PECOS, and payer enrollment processes. Strong attention to detail and organizational skills. Excellent communication and problem-solving abilities. Proficient in credentialing software, practice management systems, and Microsoft Office. Key Competencies Accuracy and compliance focus Ability to manage multiple deadlines Professional and proactive communication Strong analytical and documentation skills Confidentiality and data integrity Why Choose Total Care Therapy? At Total Care Therapy, we offer a rewarding and supportive environment to help you grow both personally and professionally. Here's what you can expect: Competitive Compensation & Benefits: Comprehensive benefits package including medical, dental, and vision insurance. 401(k) retirement plan with company matching. Work-Life Balance & Employee Perks: Paid time off to help you recharge and maintain balance. Exclusive employee perks including reduced Botox rates and a discounted Life Time gym membership. Supportive, Growth-Focused Culture: Join a therapist-owned company with a close-knit, collaborative team. Opportunities for training, mentorship, and career advancement. Ready to Join Us? If you're passionate about making a difference in healthcare and have the skills we're looking for, we'd love to hear from you! Apply now, and one of our recruiters will reach out to discuss the next steps in your journey with Total Care Therapy.

Job DescriptionBenefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Profit sharing Vision insurance Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Job Summary We are seeking a Healthcare Credentialing Coordinator to join our team! As a Healthcare Credentialing Coordinator, you will be collecting and compiling current data on all credentialed providers, verifying existing information, and tracking all expiring or changing credentials. You will also be processing applications for new credentialing or re-credentialing for providers, reaching out to providers whose credentials will be expiring, and maintaining accurate records across the board for every provider. The ideal candidate has an understanding of state regulations and credentialing, excellent organizational skills, and strong attention to detail. Responsibilities Maintain accurate records of all credentials and licensing information for all providers Organize and keep copies of all state licenses held by current providers Track expiration dates for all provider credentials and licensing Process new credentialing applications according to state regulations and requirements Maintain a high level of confidentiality Qualifications Knowledge of credentialing and licensing within the state desired Strong attention to detail Strong organizational skills The ability to multitask, and work well independently This is a remote position.