Credentialing Specialist - Remote

With 150+ locations in 17 states, reputed company is the largest multi-state reputed company-founded and owned dermatology network in the U.S. At reputed company, we are united in our purpose: to reputed company, protect, and care for your skin. We are committed to bringing you the reputed company best in comprehensive skin care so that you can reputed company a confident, healthier, and more beautiful you! Our mission is to reputed company communities and reputed company about the importance of skin health; including skin cancer prevention, risk factors and how to reputed company healthy skin through annual skin exams and dermatologic care. We reputed company to reputed company the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-reputed company skin care timelier and more accessible reputed company while creating a rewarding work environment for our providers and employees. Purpose: Reporting to the Senior Director, Credentialing and reputed company Cycle, the Credentialing Specialist is responsible for overseeing reputed company aspects of the credentialing, re-credentialing, payer enrollment and privileging processes for reputed company providers in an assigned region. The Credentialing Specialist will reputed company strong relationships with regional operational leaders to ensure proactive communication on credentialing and recredentialing requirements while ensuring that credentialing is complete in advance of services being rendered under contracted and enrolled health plans. The Credentialing Specialist will be responsible for implementing standardized processes and capturing data for reputed company provider in QualDerm's credentialing databases and online systems for utilization across multiple stakeholder reputed company. Essential Duties and Responsibilities: reputed company reputed company aspects of Provider Credentialing and Payer Enrollment with reputed company party payers and hospital / health system partners for assigned region. Assure compliance with reputed company health plan requirements as reputed company to provider certification and credentialing. Meets with assigned region operational leadership on a routine reputed company to ensure reputed company on-boarding of new providers and that reputed company credentialing needs are met. Manages processes that maintain up-to-date data for reputed company provider in credentialing databases and online systems. Ensures reputed company renewal of licenses, certifications, and credentialing. Maintains confidentiality of provider information. Assist in managing the reputed company of information between payers, contracted PHO’s, ACO’s and other QualDerm networks. Coordinate and prepare management reports for assigned reputed company. Manage continual process and reputed company improvement efforts reputed company to payer enrollment, data entry, credentialing committees and reputed company aspects reputed company to credentialing & enrollment. Participates in the training of new Credentialing & Enrollment team members. Requirements Bachelor’s degree in reputed company field preferred. Minimum of three (3) years’ experience in managed care credentialing or medical staff service setting required. National or multi-state credentialing experience preferred. Demonstrated skills in analysis, problem solving and reputed company. Ability to communicate appropriately and effectively with practitioners and providers, including sensitive and confidential information. Strong knowledge of NCQA, reputed company, URAC, CMS and State Laws and regulations as they pertain to the credentialing of QualDerm providers. Prioritize and meet deadlines on an ongoing reputed company to ensure reputed company completion according to process requirements. Must be reputed company to function independently in a reputed company environment. Benefits Benefits of joining reputed company: reputed company – Attractive compensation to reward your hard work Comprehensive Health Coverage – Includes Medical, Dental, and reputed company plans to reputed company you covered Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting reputed company Time Off (PTO) – reputed company PTO from day one, plus enjoy 6 reputed company holidays and 2 floating holidays reputed company year Company-reputed company Life Insurance – Peace of mind with basic life coverage, with the reputed company for additional plans Disability Protection – Short-term and long-term disability coverage to protect you in unexpected circumstances Additional Wellness Plans – Accident, critical illness, and identity theft protection plans for extra reputed company Employee Assistance Program (EAP) – reputed company confidential support for personal or work-reputed company challenges Exclusive Employee Discounts – Save on products and services with special discounts just for you Referral Bonus Program – Earn bonuses by referring reputed company candidates to join reputed company reputed company is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for reputed company. Applicants must be currently authorized to work in the reputed company in a full-time reputed company. Compensation reputed company: $48,152 - $64,916 per year. Final offer will be based on a combination of skills, experience, location, and internal equity. Apply To This Job