Licensing and Credentialing Specialist (Part-time)
Cayaba Care
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See open jobs at Cayaba Care.See open jobs similar to "Licensing and Credentialing Specialist (Part-time)" Seae Ventures.About Cayaba Care
Our mission is to improve outcomes in underserved communities by reimagining how maternity care is delivered. Our team is focused on building technology-enabled solutions to deliver comprehensive clinical and non-clinical maternity services in-home or in-office.
Our Values:
- Healthcare is Human: We partner with the communities we serve to address the unique needs of our patients and support whole person care.
- Pursue Excellence: We earn & build trust with our patients, partners, & each other by striving for excellence without compromising our standards.
- Uplift: We elevate and center underrepresented voices.
- Embrace Innovation: We are creative & resourceful in getting things done.
- Together, not alone: Moving maternal healthcare forward is a shared responsibility that we all care deeply about.
To learn more about Cayaba Care, please visit www.cayabacare.com.
Why You Should Join Our Team
A career at Cayaba Care is an opportunity to work towards addressing our country’s maternal and fetal health crisis. Our team is working together to help improve health outcomes in underserved populations. Opportunities for advancement with increasing administrative or management opportunities. At Cayaba Care, we are focused on building a company where individuals from all backgrounds have the opportunity to succeed and contribute to our mission. Competitive compensation and benefits.
Position Description
The Licensing and Credentialing Specialist will manage all tasks and responsibilities associated with licensing and credentialing and any other administration duties assigned by management. They will prepare and submit licensing, credentialing, and re-credentialing applications and follow up on the status of applications for Cayaba staff. This role will report to the Director of Care Operations.
Responsibilities
- Maintain compliance with all regulatory and accrediting institutions
- Monitor staff credentials and licenses, track expiration dates for licenses and certifications and advise staff on renewal procedures
- Communicate with providers to obtain any missing or updated information
- Monitor the status of credentialing applications and follow up as needed to ensure timely completion
- Collect and verify all necessary documentation for credentialing applications
- Create and implement internal credentialing processes
- Keep records in licenses, credentials and insurance contracts
- Submit credential applications to insurance companies and other relevant entities.
- Stay informed about changes in healthcare regulations and update credentialing and enrollment processes accordingly
- Generate reports and provide analysis related to credentialing and enrollment activities as needed
- Collaborate with internal teams, including billing, coding, and provider relations, to ensure seamless coordination of credentialing and enrollment processes
- Ensure compliance with all regulatory requirements related to credentialing and enrollment, including HIPAA regulations and state licensing requirements
- Review regulatory and disciplinary action reports issued by State licensure bodies, Federal agents and the Office of Inspector General Medicaid and Medicare Sanctions report (OIG), National Practitioner Data Bank (NPDB) reports; identify providers that appear in our database and invoke the appropriate process as defined in policy and procedure
Qualifications:
- Associate's or Bachelor's degree in healthcare administration, business, or a related field
- Excellent verbal and written communication skills
- Experience in healthcare industry and credentialing
- Ability to multitask and work independently
- Excellent attention to detail
- Experience with initial state licensure application submission process for multiple states
This is a part-time position initially with the potential of turning full-time by January 2025.
Job Type: Part-time
This job is no longer accepting applications
See open jobs at Cayaba Care.See open jobs similar to "Licensing and Credentialing Specialist (Part-time)" Seae Ventures.