Job Description
Job Description – Credentialing Specialist Reports To RCM Management
Summary The Credentialing Specialist is responsible for managing the credentialing and enrollment processes for VA and Medicaid providers. This role ensures compliance with state-specific requirements, maintains accurate documentation, and serves as a liaison between clients, networks, and regulatory bodies. The ideal candidate is detail-oriented, highly organized, and knowledgeable about healthcare compliance.
Job Duties - Manage the initial credentialing and re-credentialing process for VA and Medicaid providers, ensuring all requirements are met and applications are completed accurately.
- Work closely with contact managers to identify network needs and facilitate connections between clients and networks.
- Educate clients on the credentialing process and provide consistent updates to guide them through enrollment.
- Maintain accurate and up-to-date records of provider credentials, licenses, certifications, and applications.
- Ensure all credentialing activities comply with state-specific regulations and healthcare compliance standards.
- Prepare detailed reports on credentialing activities and maintain organized records for audits and inspections.
- Address and resolve any issues or discrepancies in the credentialing process.
Minimum Qualifications (Knowledge, Skills and Abilities): - Strong understanding of credentialing processes and ability to research and adhere to state-specific requirements.
- Excellent attention to detail to ensure accuracy in all tasks.
- Exceptional organizational skills to manage multiple credentialing applications and deadlines.
- Strong communication skills for effective interaction with clients, networks, and regulatory bodies.
- Solid knowledge of regulations related to VA, Medicaid, and general healthcare compliance.
- Strong problem-solving abilities to troubleshoot credentialing issues.
- Proficiency in credentialing software, database management, and the Microsoft Office Suite.
- Effective time management skills to handle competing priorities.
Experience Requirements - 2+ years of experience in credentialing, healthcare administration, or a related field.
- Demonstrated expertise in regulatory compliance and provider enrollment processes.
- Previous experience in customer service with a client-focused approach.
- Software proficiency, including credentialing platforms and database systems.
- Familiarity with insurance contracting and payer enrollment processes.
Working Conditions - Manual dexterity required to use desktop computer and peripherals
- Utilization of phone, [other software needed/required] and email to perform job functions
Compensation and Benefits: - Competitive salary and comprehensive benefits package.
- Opportunities for professional growth and career development.
- Flexible work arrangements, including remote work options.
- Health, dental, and vision insurance.
- 401(k) plan with company matching.
- Company will provide laptop and other needed computer equipment.
About AxisCare According to Pew Research, roughly 10,000 baby boomers turn 65 every day, and the American Society on Aging calculated that an American has a 70% chance of needing help with activities of daily living such as dressing, bathing, hygiene, etc. This has led to an unprecedented increase in Home Care agencies in the U.S. and abroad who strive to help those who have difficulty helping themselves, specifically offering non-medical (also referred to as non-skilled) services to seniors in their homes.
AxisCare was started in 2011 by industry leaders to help meet the demand for a more user-friendly and mobile-compatible solution. Our product is a web-based management platform that helps agencies manage CRM and marketing, Caregiver/Client scheduling, billing, payroll and much more. Headquartered in Waco, TX, AxisCare has clients in all 50 states as well as 6 other countries We are a fast-growing company seeking high-performing individuals looking for a fast-paced, autonomous working environment. We are an Equal Opportunity Employer and comply with ADA regulations as applicable.
Job Tags
Full time, Flexible hours,