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Credentialing Specialist (Full-Time Hourly - Remote)

Season Health

Season Health

Administration
Remote
Posted on Wednesday, June 5, 2024

About the Role

As the Credentialing Specialist, you will own all aspects of credentialing including data management: individual applications, group applications, PTAN applications (new and reassignments), payer portal attestations, and maintenance as needed. You will be responsible for updating and maintaining our credentialing data warehouse to ensure all documentation is up to date, maintaining the w2 employee roster and 1099 contractor roster. You will work with the clinical team as needed to acquire documentation and ask any questions that come up during the credentialing process. This role will report to the Network Operations Manager.

About Season

Season Health is the only integrated clinical nutrition solution that drives engagement, outcomes, and cost-of-care reduction across populations, powered by its food-as-medicine platform. With one of the largest networks of registered dietitians and a curated food market of national and local vendors, Season empowers individuals and their families to make informed, sustainable choices, measurably improving both health outcomes and quality of life. Learn more at www.seasonhealth.com

Responsibilities

  • Completing and submitting individual, group applications
  • Experience working in PECOS completing PTAN (new and reassignments) applications
  • Payer Portal attestations and maintenance
  • Updating and maintaining our credentialing data warehouse
  • Maintaining W2 employee roster and 1099 contractor roster
  • Highlighting any significant errors found in Portals, Contracts, Provider Data, Rosters, and working through solutions to correct them.
  • Calling health plans for panel status, application status, etc.
  • Knowledge of Post-contract execution EDI/ERA/EFT setup
  • CAQH maintenance and Availity updates

About You

  • In-depth full circle knowledge of the credentialing process and credentialing terminology
  • Experience with individual provider and group credentialing
  • 2 + years experience communicating with health plans to facilitate credentialing
  • 2 + years experience with CAQH, Availity and Payer Portals required
  • 3 + years experience with Google workspace and Excel
  • Exceptional written and verbal communication skills, with an attention to detail when compiling documentation
  • A self-starting mindset and high sense of ownership; you readily identify blockers to progress as well as opportunities for improving existing ways of doing things.
  • An ability to learn quickly and have a comfort with ambiguity and a faster pace of working.

Compensation and Benefits

  • The salary range for this role is $19-28/hr commensurate with experience
  • Full-time hourly role in a fully remote environment
  • Medical, dental, and vision benefits provided to you and your dependents at no cost
  • Option to participate in 401k plan
  • Flexible work arrangements and paid time-off
  • An opportunity to use your skills to help improve nutrition and population health at a mission-driven company

Interested? How to Apply:

To apply, please send us your resume (no cover letter is required). If selected, you will be invited to a :30 minute phone interview to get an overall sense of your experience. Following a successful phone screen, you will be asked to return to do a technical assessment and final interview which will be approximately one hour.

In addition to the Credentialing Specialist role, we have an opening for a Part-Time Credentialing Analyst. If you are interested in this role please indicate in the application form.

More about Season

Season is a series-A stage business backed by Andreessen-Horowitz, LRV Health, 8VC, Bain Capital, Healthy.VC and Grand Central Tech among others.

Season recruits, employs, compensates, and promotes regardless of race, religion, sex, national origin, ethnicity, gender identity, disability, age, veteran status and other protected status as required by applicable law and as a matter of our company ethics.