Credentialing Specialist (55159)

Exciting Opportunity: Join Our Talented Team as a Credentialing Specialist!

Are you ready to make a difference in peoples lives while enjoying a work-life balance Rehab Resources & Greenfield Rehabilitation is looking for a dedicated Credentialing Specialist to join our dynamic team and help us continue providing exceptional physical occupational and speech therapy services to patients of all ages from pediatrics to adults.

At Rehab Resources/Greenfield Rehabilitation we pride ourselves on our core values of Agility Integrity and Community. We offer a supportive work environment where youll feel empowered to make an impact all while enjoying a work life balance hours and a rewarding career. Hours: Monday to Friday 8:00 AM - 4:00 PM CST. The role is open to a hybrid schedule (a combination of remote and in-office work) after the probationary period.

Position Overview

As a Credentialing Specialist youll be an essential part of our operations. Youll manage the credentialing and enrollment process for government and commercial payers ensuring a smooth experience for our providers. From initial enrollments and CAQH application monitoring to revalidation processes your role will involve working closely with insurance provider relations representatives CAQH and our internal team to resolve any issues that arise.

Key Responsibilities

Manage Credentialing & Enrollment: Oversee the initial provider enrollment CAQH monitoring and revalidation processes for both government and commercial payers.

Collaborate for Success: Work with insurance provider relations representatives CAQH and our internal team to ensure seamless enrollments and resolve any issues that arise.

Multitask & Problem Solve: Navigate multiple systems and tasks simultaneously ensuring accuracy and timeliness in all processes.

Why Choose Rehab Resources/GRA

Therapist-Owned & Operated: We are therapist-owned committed to seamless operations for our pediatric therapy services.

Core Values: Agility Integrity and Community are at the heart of everything we do.

Competitive Pay & Benefits: Enjoy comprehensive health insurance PTO sick time 401K with matching flexible schedules and much more!

Required Experience

Proficiency in Excel Word and Outlook

Strong ability to multitask and take ownership of processes

Self-motivated and able to work independently

Tech-savvy and comfortable navigating multiple computer systems and screens

Ability to perform under pressure in a fast-paced environment with tight deadlines

Experience with Medicare and Medicaid Provider enrollments including revalidations

Familiarity with insurance websites (e.g. CAQH Waystar)

Knowledge of NCQA standards

Skill set of optimal candidate:

Understanding of the 1500 Claim Form

Experience with Clearing House systems such as Waystar

Medical billing experience

Familiarity with credentialing software platforms

Credentialing certification (CPCS) is a plus but not required

Qualifications

At least 18 years of age.

High school diploma or equivalent.

Advanced training in medical credentialing as noted above