Credentialing Specialist
About the role
The Credentialing Specialist will be responsible for owning health plan enrollment applications across group and individual submissions for both Medicaid and Commercial payors. You will be responsible for owning states and health plans, ensuring that all new provider and health plan applications are completed and approved in a timely manner. Monitoring application progress and proposing solutions for resolving credentialing delays and rejections will be key aspects of your responsibilities. Your attention to detail and proactive approach will be essential in facilitating a smooth enrollment process.
Responsibilities
- Complete health plan enrollment applications for both group and individual submissions across Medicaid and Commercial payers.
- Communicate directly with providers to gather necessary information for credentialing application submissions.
- Ensure adherence to application requirements to guarantee all required information is submitted to health plans.
- Follow up on outstanding enrollments through phone, email, and portal to expedite provider enrollment approval.
- Monitor application progress and propose solutions for resolving credentialing delays and rejections.
- Track application progress and follow-ups directly in Salesforce.
Requirements
- Bachelor's degree
- 2+ years working in health plan enrollment is preferred
- Experience with Medicaid enrollment is preferred
- Work authorized in the United States and native or bilingual English proficiency
- Familiarity with and willingness to use cloud-based communication software—Google Suite, Slack, Zoom, Dropbox, Salesforce
Benefits
Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.
Pay
The total target base compensation for this role will be between $40,000 and $53,000 per year at the commencement of employment. In addition to base compensation, this role also offers a performance bonus. The expected total cash compensation range, including potential bonus, will be between $41,000 and $55,000 per year.