Amenity Health, Inc.
About Us
At Amenity Health Services, we're on a mission to make a difference in the lives of those we serve, in a positive and caring matter so that they may have a better tomorrow. We want to be the steppingstone or building blocks that we are called on to be for children and their families. We believe in doing meaningful work, treating people with respect and building a culture where everyone feels valued and empowered to grow.
If you're excited about making an impact and being part of a team that values sincerity, ownership, advocacy and resilience - We'd love to hear from you.
Work Overview
We are looking for a Credentialing Specialist that plays a key role in supporting the Compliance Coordinator with the credentialing process of providers and promoting organizational compliance with legal, regulatory and internal standards. The Credentialing Specialist will be responsible for assisting with day to day operations of credentialing and re-credentialing including CAQH, communicating with payors (commercial and non-commercial) and ensuring all qualifications and needs are maintained in accordance with regulatory and payor requirements.
Key Responsibilities Supporting the development and implementation of the credentialing process policies and procedures Responsible for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry and document review Compliance with HMA policy and procedure, federal and state regulatory and accrediting agencies is required Maintain high quality, timely and accurate credentialing processes of medical and allied healthcare professionals per policy and procedure Assist in the credentialing process by entering/logging/scanning information into credentialing system for initial, updated, add on applications and maintenance processes Acts as liaison with MSO as point person for completing and ensuring compliance and delivery of required information in a timely manner Process and maintain credentialing and re-credentialing in accordance with policy and procedure, state and federal regulatory regulations Monitor collection of all information received, follow up with missing items and/or incomplete forms per policy and procedure, submit follow-up requests for verifications as needed Identifies and evaluate potential red flags and works in collaboration with practitioners to and management to document the issue Completes applications for insurance panels, licensing boards and other regulatory bodies Monitoring credential statuses and proactively communicates updates or issues with leadership and relevant departments Assist the Compliance Coordinator with the development, implementation and review of internal policies and procedures Help identify noncompliance issues and support in creating action plans to resolve them Support compliance tracking and reporting to ensure adherence to federal, state and industry specific regulations Stay informed of changes in healthcare regulations and assist in updating internal protocols accordingly Perform administrative and research tasks as assigned to support overall compliance and credentialing initiatives Benefits
Benefits are offered to full time employees who work 30 hours or more a week. Full time employees are eligible for benefits at 90 days of employment.
Health Insurance Vision Insurance Dental Insurance Critical Illness 24 Hour Accident Life Insurance and more! PTO Paid Holidays We believe people do their best work when they're supported-professionally, financially, and personally. We can offer
Competitive hourly ranges Ongoing performance evaluation Professional Development Opportunities A team that values transparency, kindness and accountability A culture where your voice is heard and your work matters Requirements
Bachelors degree or experience in medical credentialing Experience with CAQH Experience with credentialing medical providers Great customer service skills
If this role sounds like a great fit, we'd love to hear from you! Please submit your resume and complete the application process.
We're committed to building a team where everyone can thrive. Lets build something great together!
At Amenity Health Services, we're on a mission to make a difference in the lives of those we serve, in a positive and caring matter so that they may have a better tomorrow. We want to be the steppingstone or building blocks that we are called on to be for children and their families. We believe in doing meaningful work, treating people with respect and building a culture where everyone feels valued and empowered to grow.
If you're excited about making an impact and being part of a team that values sincerity, ownership, advocacy and resilience - We'd love to hear from you.
Work Overview
We are looking for a Credentialing Specialist that plays a key role in supporting the Compliance Coordinator with the credentialing process of providers and promoting organizational compliance with legal, regulatory and internal standards. The Credentialing Specialist will be responsible for assisting with day to day operations of credentialing and re-credentialing including CAQH, communicating with payors (commercial and non-commercial) and ensuring all qualifications and needs are maintained in accordance with regulatory and payor requirements.
Key Responsibilities Supporting the development and implementation of the credentialing process policies and procedures Responsible for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry and document review Compliance with HMA policy and procedure, federal and state regulatory and accrediting agencies is required Maintain high quality, timely and accurate credentialing processes of medical and allied healthcare professionals per policy and procedure Assist in the credentialing process by entering/logging/scanning information into credentialing system for initial, updated, add on applications and maintenance processes Acts as liaison with MSO as point person for completing and ensuring compliance and delivery of required information in a timely manner Process and maintain credentialing and re-credentialing in accordance with policy and procedure, state and federal regulatory regulations Monitor collection of all information received, follow up with missing items and/or incomplete forms per policy and procedure, submit follow-up requests for verifications as needed Identifies and evaluate potential red flags and works in collaboration with practitioners to and management to document the issue Completes applications for insurance panels, licensing boards and other regulatory bodies Monitoring credential statuses and proactively communicates updates or issues with leadership and relevant departments Assist the Compliance Coordinator with the development, implementation and review of internal policies and procedures Help identify noncompliance issues and support in creating action plans to resolve them Support compliance tracking and reporting to ensure adherence to federal, state and industry specific regulations Stay informed of changes in healthcare regulations and assist in updating internal protocols accordingly Perform administrative and research tasks as assigned to support overall compliance and credentialing initiatives Benefits
Benefits are offered to full time employees who work 30 hours or more a week. Full time employees are eligible for benefits at 90 days of employment.
Health Insurance Vision Insurance Dental Insurance Critical Illness 24 Hour Accident Life Insurance and more! PTO Paid Holidays We believe people do their best work when they're supported-professionally, financially, and personally. We can offer
Competitive hourly ranges Ongoing performance evaluation Professional Development Opportunities A team that values transparency, kindness and accountability A culture where your voice is heard and your work matters Requirements
Bachelors degree or experience in medical credentialing Experience with CAQH Experience with credentialing medical providers Great customer service skills
If this role sounds like a great fit, we'd love to hear from you! Please submit your resume and complete the application process.
We're committed to building a team where everyone can thrive. Lets build something great together!