Credentialing Specialist

Are you looking for an incredible opportunity to join a dynamic, fast-growing dermatology services company? Epiphany Dermatology, headquartered in Austin, TX, is on a mission to improve access to dermatology services and provide exceptional patient care in underserved markets across the U.S.

We are looking for a service-oriented, motivated individual to join us as a Credentialing Specialist to accomplish this mission. With ambitions to increase our reach over the years, our quickly expanding company has gone from a single site in 2015 to over 100 dermatological clinics nationwide.

Our employees are the key to our success and we’re proud to offer eligible employees great benefits (many at no cost!), perks like free skin care, generous time off plans, the opportunity for growth, and the chance to be part of a purpose-driven organization taking patient care to the next level.

We are excited to grow our team with individuals who are as passionate about our patients as we are and invest a lot of time and energy in our employees’ development because we believe being a part of the Epiphany team is a career opportunity and not just another job.

If you are interested in joining this mission-driven team, please consider applying today!

What we are looking for:

An organizational guru who excels when given a deadline! In this role you will be responsible for processing, monitoring, and maintaining the initial provider enrollment and re-credentialing process for our amazing providers. On a daily basis you will be asked to facilitate all aspects of credentialing and payor enrollment for Epiphany Dermatology providers and clinics. If you are up to the challenge of being held responsible for the accuracy, integrity and management of the credentialing database system and related applications… we want to talk to you!

What you will do:

• Lead, coordinate, and monitor the review and analysis of provider applications and accompanying documents, ensuring applicant eligibility.
• Maintain all aspects of the payer credentialing process with the goal of becoming in-network providers for strategic insurance plans for multiple service lines.
• Manage the credentialing database system and related applications.
• Conduct thorough background investigation, research, and primary source verification of all components of the application file.
• Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow up.
• Prepare credentials file for completion and presentation to CEO/Medical Directors, ensuring file completion within time periods specified.
• Process requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions.
• Respond to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
• Lead care delegated credentialing audits; conducts internal file audits.
• Other duties as assigned.

It’ll help to have/be:

• High school diploma or equivalency certificate required: associate degree highly preferred.
• Knowledge and understanding of Licensing, Board certification, DEA certification, CAQH, PECOS and other relevant provider enrollment systems - preferred

Qualifications/Experience:

• Specific credentialing / payor enrollment experience, 6 months minimum.
• Understanding of basic credentialing and payor enrollment functions and terminology.
• Must be available to accommodate an onsite, in-person schedule based out of our Austin HQ.

Work Environment and Physical Requirements:

Administrative office may have minimum visits to medical offices with possible exposure to procedure/exam room and laboratory environment may include exposure to communicable diseases, bloodborne pathogens, biohazards or toxic substances. Daily activities may include standing, walking, sitting, bending and lifting items up to 30 lbs.

Benefits:

We offer generous benefits including medical, life insurance, short-term disability coverage, mental health services, and more at no cost for eligible employees. In addition, we have great vision, dental, and supplemental insurance options. We also offer 401k with company matching, employee discounts, HSA and FSA, tuition assistance, certification reimbursement, and more!