Remote Certified Provider Credentialing Specialist

Summary

Join Circle Medical as a Certified Provider Credentialing Specialist (CPCS) and play a key role in supporting the Director of Compliance & Policy. As a subject matter expert, you will monitor provider credential and licensure status across all 50 states, implement an effective credentialing program, and lead staff coordination and administration.

Requirements

• 5+ years of credentialing experience with medical staff
• CPCS or CPMSM certification
• Proficiency in using credentialing software and databases
• The ability to think logically and analytically to problem-solve on a daily basis
• Have emotional intelligence and the ability to possess self-awareness and base decisions on your analysis of facts
• Strong time management and prioritization skills to make sound business decisions
• In-depth knowledge of the clinical, healthcare, and telemedicine standards, regulations, and medical credentialing and privileging procedures and standards
• Excellent communication skills; written, verbal, as well as auditory
• Familiarity with healthcare, telehealth, and regulatory terminology
• Professional integrity to adhere to professional confidentiality standards in accordance with HIPAA, legal, ethical, and company policies
• Critical thinking skills to exercise sound independent judgment and discretion in applying departmental policies and procedures while handling confidential medical staff, risk management, and peer review information

Responsibilities

• Track credentialing and licensing status for our providers
• Implement and manage an effective credentialing and licensure program
• Lead and monitor all credentialing, re-credentialing, and provider enrollment processes
• Maintain a database of provider certifications and renewal dates
• Confirm that provider credentials match the requirements of their job
• Help full-time providers apply for or renew credentials which may include finding test dates and locations, identifying CME requirements, or submitting applications and payments on their behalf
• Ensure staff coordination and administration of the credentialing and licensing process for certified staff and providers
• Assist with cross-state licensure process
• Review, analyze and create practitioner credentialing applications, privileging forms, and standardized communications in an effort to improve communication and compliance
• Identify and communicate all concerns regarding practitioner credentialing and enrollment to appropriate parties; follow up when necessary to ensure affected parties and departments are notified of concerns in an appropriate time frame
• Monitor for provider sanctions and collaborate with appropriate teams to action accordingly
• Develop and review company policies
• Communicate with government agencies

Benefits

• Transparent salaries based on location, output levels, and options to trade cash for stock
• Full-time, salaried position with an annual compensation of $64,500 - $65,700 USD
• Generous vacation
• Full medical/dental benefits
• 401K + Company Matching Program