KeyCare · 15 hours ago
Credentialing Analyst
Greater Chicago Area
Full-time
Remote
Entry, Mid Level
2+ years exp
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Responsibilities
Manage all aspects of the credentialing and re-credentialing processes for telehealth providers, including initial applications, renewals, and updates.
Verify provider credentials such as licensure, education, certifications, DEA registration, and malpractice insurance.
Coordinate and monitor provider enrollment with insurance payers, including Medicare and Medicaid, and ensure compliance with payer-specific requirements.
Maintain detailed and accurate records of provider credentialing statuses and documentation in the credentialing database.
Ensure timely processing of credentialing applications to meet operational and regulatory deadlines.
Ensure credentialing processes comply with all applicable state and federal regulations, including telehealth-specific requirements.
Keep up-to-date with changes in laws, regulations, and payer policies affecting provider credentialing and licensure in multiple states.
Prepare and submit documentation for audits, surveys, or other regulatory reviews.
Serve as the primary point of contact for providers throughout the credentialing process, addressing questions and resolving issues promptly.
Collaborate with internal teams, including recruitment, operations, and billing, to align credentialing workflows with onboarding and insurance enrollment needs.
Work with external stakeholders such as payers, licensing boards, and accrediting bodies to expedite credentialing and resolve discrepancies.
Track and report key credentialing metrics, including application status, completion rates, and compliance updates.
Maintain up-to-date records in credentialing software and ensure data integrity.
Generate reports for leadership on credentialing performance, bottlenecks, and process improvement opportunities.
Qualification
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Required
2+ years of experience in provider credentialing, payer enrollment, or healthcare operations, preferably in a telehealth or multi-state practice setting.
Strong understanding of credentialing workflows, state licensing requirements, payer enrollment, and healthcare regulations.
Familiarity with CAQH, NPPES, Medicare PECOS, and telehealth-specific guidelines.
Excellent organizational skills with strong attention to detail.
Proficiency in credentialing or healthcare management software (e.g., Symplr, Modio, or similar).
Ability to analyze and improve credentialing workflows.
Strong written and verbal communication skills, with ability to effectively collaborate across teams and engage with providers and clients.
Knowledge of HIPAA and regulatory standards related to telehealth and credentialing.
Preferred
Bachelor’s degree in Healthcare Administration, Business Administration, or a related field
Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC)
Company
KeyCare
KeyCare is a virtual care platform powered by Epic created to support progressive health systems.
11-50 employees
Funding
Current Stage
Early StageTotal Funding
$27M2022-08-17Series A· $27M
Leadership Team
Lyle Berkowitz
Founder and CEO
Recent News
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