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Akido Labs · 23 hours ago

Credentialing Specialist

Pomona

Full-time

Onsite

Mid Level

$24/hr - $34/hr

3+ years exp

Akido Labs is an AI-powered care provider aiming to address the physician shortage in America. As a Credentialing Specialist, you will ensure that providers are credentialed and enrolled accurately and efficiently, allowing for uninterrupted patient care.

Health CareInformation Technology

Growth Opportunities

Responsibilities

Filling out provider enrollment applications with health plans, Medicare, Medicaid and hospitals

Following up with health plans and hospitals on submitted applications

Solve complicated credentialing-related issues directly with IPAs and health plans

Maintaining a clean database of provider data and enrollment-related activities in MD Staff

Applying for license renewals

Communicating with providers on credentialing-related updates

Work amongst a team of credentialing/enrollment specialists to deliver accurate, timely, and compliant work - including completing credentialing/enrollment tasks

Process credentialing, re-credentialing, and privileging applications to keep providers active and patient care uninterrupted

Solve enrollment-related issues as they arise, working directly with health plans to get them resolved

Monitor application timelines to prevent delays and resolve escalated issues from staff, clinics, and providers

Maintain high data quality, including both provider data as well as credentialing data, like expiration dates, contact information, etc

Follow SOPs and policies that are designed to streamline workflows and strengthen compliance

Maintain compliance with the state, federal, and payer-specific credentialing requirements

Act as a liaison for external partners, including payers, hospitals, and credentialing verification organizations

Qualification

Provider credentialingNCQA standards knowledgeCredentialing software experienceProblem-solving skillsCommunication skillsOrganizational skillsAttention to detail