SimiTree Healthcare Consulting
Credentialing Specialist (Fully Remote)
PayCompetitive
LocationRemote
Employment typeFull-Time
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Job Description
- Req#: 25-01070
- Process initial credentialing and re-credentialing applications for providers and practice groups.
- Monitor, track and follow up on all applications with payers until completion of the process.
- Screen providers’ applications and supporting documentation to ascertain their eligibility.
- Accurately maintain internal credentialing tracking system with provider and payer participation information.
- Identify discrepancies in information and conduct follow ups.
- Capture primary source verification documentation.
- Build knowledge base for payer requirements and forms.
- Ensure compliance with applicable laws regulations, procedures, and policies.
- Perform CAQH updates and attestations as needed.
- Work with internal RCM team members to identify and resolve credentialing issues and denials.
- Work closely with the Account Success Team for any client credentialing requirements
- Work closely with the Account Success Team and Business Development to onboard new clients and ensure accurate registration with appropriate payers
- Advanced software and computer skills including Microsoft Suite applications; specifically, Word, Excel, and PowerPoint is required.
- Excellent time management skills, experience of working on multiple tasks, being able to manage busy workloads, prioritizing accordingly and meeting deadlines.
- Strong customer service skills and ability to interact with employees at all levels throughout the organization, also with external clients when appropriate
- Self-starter with a positive, “can-do” and professional approach.
- Ability to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, and policies.
- Minimum of Associate degree or equivalent combination of education and experience in Credentialing
- 2+ years provider credentialing experience with knowledge of payer policies for multiple states.
- Experience working in Microsoft Outlook and TEAMS preferred.
- Experience working in a fully remote setting preferred.
- Activities requiring a significant amount of sitting at office and work desks in front of a computer monitor.
- Regularly required to verbally communicate, listen, and give presentations as needed.
Credentialing Specialist (Fully Remote)
The Credentialing Specialist will perform as the Provider Enrollment Specialist to ensure the team is poised to support the business leaders in their accordance with the company’s strategic plans and objectives.
About SimiTree
SimiTree provides client-centric services to home health, hospice, private duty, pediatrics, applied behavioral analysis, palliative care, and other post-acute organizations. Our organization is made up of clinical, operational, and revenue cycle experts who support our clients. SimiTree has developed a full suite of custom-designed services focusing on areas critical to quality improvement, operational efficiency, accurate reimbursement, and regulatory compliance.
To provide our clients with an opportunity to focus on core operations, SimiTree provides outsourcing services for Coding and OASIS reviews, Billing and Collections, and full Revenue Cycle services. SimiTree's client base ranges from small, community-based agencies to publicly traded national chains. We have both the technical expertise and the real-world experience to implement seamless solutions that assist agencies in a rapidly changing operational and regulatory environment.
Duties/Responsibilities:
Competencies/Behaviors:
Physical Requirements:
Salary range/ Benefits:
$20.00- $22.00 per hour
The compensation scale listed is a general salary range and is not intended to represent the actual annual or hourly compensation rate for this role. An offer will be made to the selected candidate at the conclusion of the interview process based on their relevant experience and the responsibilities of the position. SimiTree offers a competitive compensation package including health, vision, and dental insurance, PTO, retirement plans (401K), holiday paid time off, life insurance, sick time, and opportunities for professional development.
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About the company
SimiTree Healthcare Consulting unites former Simione and BlackTree experts, services, and approaches to help post-acute organizations raise performance levels and realize revenue potential in a complex market. SimiTree's services include Consulting, Mergers & Acquistions, Talent Solutions, Data Analytics, and Outsourced Services for home health, hospice, and palliative industries.