Credentialing Associate

Responsibilities

• Ensure all necessary documents (licenses, contracts, tax information, etc.) are submitted to payors and are current to meet enrollment and revalidation requirements.
• Act as the point of contact for resolving enrollment issues, such as rejections, delays, or discrepancies, by communicating directly with payors.
• Monitor and track revalidation deadlines for providers to ensure timely re-enrollment and prevent disruptions in reimbursement.
• Maintain records and provide reports on the status of payor enrollments, including completed, pending, and rejected applications.
• Ensure timely re-attestation of CAQH profiles.

Qualifications

• Minimum 1-3 years experience in credentialing and payor enrollment, including maintaining in-network contracts/enrollments with private and public payors.
• Knowledge of State Medicaid (including Managed Medicaid Care Organizations), Medicare, commercial/private health plans, and insurance carriers.
• Knowledge of PECOS system.
• Experience working with major payors like UnitedHealthcare, Aetna, Cigna, Blue Cross Blue Shield, etc.
• Strong attention to detail and accuracy.
• Excellent organizational and prioritization skills.
• Team-oriented with a collaborative mindset.
• Receptive to feedback and continuous improvement.
• Certification in payer enrollment, healthcare administration, or a related field is a plus (e.g., Certified Professional Coder - CPC or other relevant certifications).
• Experience working from home is preferred.

Benefits

• 3 Weeks PTO + 8.5 days of additional sick time + 10 paid holidays
• Paid parental leave
• 100% Employer Paid Medical, Dental, and Vision Insurance
• Employer Paid STD & LTD
• 401k
• $50 monthly Remote Work Stipend

About the role

The Credentialing Associate is responsible for ensuring that healthcare providers are properly enrolled with insurance companies, government programs, and other third-party payers to ensure proper reimbursement for services provided.

Schedule

This is a full-time (40hrs per week) remote position.

Pay

Target Pay Range: $28-30/hr - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Benefits

• 3 Weeks PTO + 8.5 days of additional sick time + 10 paid holidays
• Paid parental leave
• 100% Employer Paid Medical, Dental, and Vision Insurance
• Employer Paid STD & LTD
• 401k
• $50 monthly Remote Work Stipend

Equal Opportunity Employer

Bicycle Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or any other basis forbidden under federal, state, or local law.