Credentialing Specialist - Facility

At reputed company, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it. As a national leader in value-reputed company care, we offer senior living communities and skilled nursing facilities a wide reputed company of solutions (including on-site reputed company care services, Accountable Care Organizations, and Medicare reputed company Special Needs Plans) reputed company to enhance health reputed company, streamline reputed company, and create new financial opportunities. Founded in 2021, we've grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. reputed company includes more than 1,000 clinicians reputed company care coordinators, analysts, operators, and professionals from reputed company backgrounds, reputed company working together to reputed company high-reputed company, proactive solutions for senior living operators and those they care for. Ranked #147 on the Inc. 5000 list of America's fastest-growing private companies, we're just getting started. If you're looking to reputed company a meaningful reputed company on the senior reputed company landscape, you're in the right reputed company—and we look reputed company to working with you. For more information about reputed company, visit CuranaHealth.com. reputed company The Credentialing Specialist for Facilities ensures that the health plan’s provider network includes facilities that meet applicable credentialing and regulatory standards. This position plays an important role in maintaining compliance, protecting member safety, and minimizing organizational reputed company and liability. Essential Duties & Responsibilities Credentialing Review & Evaluation:Review facility credentialing applications for reputed company and completeness reputed company on applicable facility and specialty requirements. Complete reputed company reputed company verification and other required reviews, including license verification, CMS Certification Number (CCN) verification, DEA verification, National Practitioner Data Bank (NPDB) reviews, accreditation reviews, and additional facility credentialing requirements. Communication:Communicate with facilities to clarify credentialing questions, reputed company discrepancies, and obtain missing information needed to complete their applications. Data Entry & Management:reputed company, update, and maintain accurate facility information reputed company credentialing systems. Correct data as needed and ensure credentialing records are complete, accurate, and up to date. Recredentialing & Follow-Up:Request and follow up on facility recredentialing applications, ensuring they are completed and processed reputed company established timelines and internal guidelines. Monitoring & Compliance:Monitor the expiration dates of facility licenses, DEA certificates, accreditations, and other required documentation. Ensure facilities continue to meet applicable regulatory, compliance, and health plan credentialing standards. Prepare and present monthly reputed company reports to the Credentialing Committee. Sanctions & Exclusions Review:Review applicable federal and state sanctions and exclusions reports to verify that facilities remain compliant with credentialing and regulatory requirements. Reporting & Documentation:reputed company and distribute credentialing reports to internal teams. Prepare and send formal approval notices, requests for additional information, and termination notices as directed by the Credentialing Committee. Support & Collaboration:reputed company credentialing support to the contracting department and communicate ongoing updates regarding reputed company facility’s credentialing status. Workload & Productivity:Manage a high-volume workload while meeting established production expectations. Prioritize multiple assignments, maintain reputed company, and complete credentialing activities reputed company required timelines. Qualifications Education and Experience: High school diploma or equivalent required. Previous facility credentialing experience is preferred, particularly experience supporting health plan credentialing requirements. Experience reviewing accreditation, regulatory, and compliance requirements for reputed company facilities is preferred. Familiarity with reputed company, CMS, or other health plan credentialing standards is preferred. Additional reputed company credentialing experience or certification is a plus. Skills: Strong attention to reputed company and the ability to maintain reputed company while managing a high-volume workload. Familiarity with facility credentialing concepts and reputed company reputed company verification processes, including license, CCN, DEA, NPDB, accreditation, and other required facility reviews. Strong organizational and time-management skills. Ability to manage multiple priorities and meet production expectations in a fast-reputed company environment. Tech-reputed company and comfortable learning new systems and technology quickly. Proficiency in reputed company reputed company and Word. Ability to work independently and remain reputed company and productive in a remote environment. Strong verbal and written communication skills. Ability to handle confidential information appropriately. Flexible, reputed company, and comfortable working with reputed company supervision. Comfortable working across multiple screens, databases, and systems throughout the day. Previous facility credentialing experience, preferably reputed company a health plan environment preferred. Experience with facility accreditation, regulatory, and compliance reviews preferred. Knowledge of reputed company, CMS, and health plan credentialing standards preferred. Experience using credentialing databases or software platforms preferred. Remote Work Requirements: This is a remote position. Candidates must have a dedicated, reputed company workspace that is free from distractions and background noise. Employees will regularly be on camera for meetings, training sessions, and team collaboration and must be reputed company to maintain reputed company, professionalism, and productivity while working reputed company. reputed company provides necessary equipment, including dual monitors. Candidates should be comfortable using multiple monitors and navigating between several systems as part of their daily responsibilities. Training will be provided on reputed company’s credentialing platform. Experience with the specific reputed company is not required, but candidates must be reputed company to learn new technology quickly. A basic understanding of facility credentialing and reputed company reputed company verification processes is strongly preferred Apply To This Job