What are the responsibilities and job description for the Credentialing Specialist position at Upward Health?
We are seeking a motivated individual to join the Upward Health Business Services team in the Credentialing Specialist role. This position will play a key role in ensuring that our provider team is enrolled with relevant health plans and ready to support our patients. The role will be responsible for payer enrollments for all newly hired and/or licensed providers and ensure that applications are tracked from submission through approvals.
The strongest applicants to this role will be experienced with credentialing at an individual level. Comfort and knowledge of group credentialing and individual provider licensing is a plus. You should be detail-oriented, highly organized, responsible, independent, and an excellent communicator. It’s valuable to enjoy a fast-paced, goal-oriented environment. Flexibility and responsiveness to a dynamic workload is important. This role reports to our Director, Business Services.
KEY RESPONSIBILITIES:
- Submission of individual credentialing applications for all newly hired and/or licensed providers for relevant health plans in a given region
- Communication of approvals to key team members
- Updating internal tracking systems for all submissions, approvals, and other relevant status updates
- Assistance for both group and individual credentialing applications for Medicare and Medicaid
- Assistance with individual licensing needs, including renewal processes
KNOWLEDGE, SKILLS & ABILITIES:
- Detail orientation and proven organizational skills
- Excellent written and verbal communication
- Highly flexible to our dynamic work environment. The ability to change directions quickly is important.
- Ability to multi-task and to create and manage work lists
- Ability to work independently and in a highly virtual environment, with colleagues all over the country
- Strong technology skills and ability to master working across a range of software programs, including Microsoft Office applications, Jira, and various clinical applications (EHR, care management system)
- Strong work ethic and willingness to work long hours, including nights and weekends when required
MINIMUM QUALIFICATIONS:
- Bachelor’s degree
- 2 years of professional experience working with health insurance companies (preferred), healthcare provider organizations, or other healthcare services companies, as the comfort and understanding of the business language and demands of our clients is critical
