Credentialing Specialist

ReveLution is a growing third-party billing, consulting, and medical administration company committed to providing the highest quality of billing services to our clients. We are currently seeking a Credentialing Specialist to work alongside our Lead Credentialer and support this growing service line. We are seeking an individual who has experience in a related role and demonstrates a drive to excel. We seek to bring on team members who take great pride in their work to join our dynamic, growing team.

JOB SUMMARY:

ReveLution's Credentialing Specialists are responsible for providing 3rd party credentialing services on behalf of ReveLution's clients. This includes supporting the initial credentialing and reappointment processes with facilities (i.e. hospitals, medical staff privileges, etc.), networks, insurance plans, and more. This position will support and work in tandem with the Lead Credentialer as well as work independently on some credentialing client accounts.

The successful candidate is very organized and detail-oriented, has a base knowledge of credentialing, is comfortable interacting with providers related to the credentialing process, and provides consultation to client providers regarding credentialing. This position will be required to ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation. Additionally, it is important for any individual considering this position to have strong computer skills as we are an almost paperless company and conduct all credentialing work through fillable forms, DocuSign/e-signing applications, e-faxing, and other computer applications.

SCHEDULE: Full time; Monday-Friday. Available schedule options -

• 7:00 am - 3:30 pm (AZ Time)
• 7:30 am - 4:00 pm (AZ Time)
• 8:00 am - 4:30 pm (AZ Time)
• 8:30 am - 5:00 pm (AZ Time)
• 9:00 am - 5:30 pm (AZ Time)

LOCATION:

• This role is exclusively telecommuting/remote work with the option to occasionally work on-site at an office for Arizona local employees.

PRIMARY JOB DUTIES:

• Responsible for timely processing of initial applications and reappointment applications.
• Maintaining tracking spreadsheets and a credentialing database to ensure timely and complete credentialing processes.
• Obtaining and maintaining primary source information.
• Applying for CAQH and maintaining CAQH profiles.
• Maintaining provider rosters with current information to submit to insurers.
• Working directly with physicians and mid-level providers to obtain information and signed documentation to complete initial and reappointment applications.
• Supporting the day-to-day work of the Lead Credentialer through delegated tasks/assignments.
• Working directly with insurance companies to resolve any provider loading discrepancies as they arise.

QUALIFICATIONS:

• 1+ year(s) in a credentialing role.
• Experience with Arizona insurances preferred but not required.

SKILL SETS:

• Detail-oriented.
• Highly organized.
• Self-starter and comfortable working remotely on independent tasks.
• Proficient in computers and navigating various applications (CAQH, credentialing databases, Microsoft Office applications, etc.).
• Exemplary written and verbal communication skills.

Pay Scale: This position starts between $18.00 - $22.00 based on applicable experience.

Job Type: Full-time

Benefits:

• Health insurance
• Vision insurance
• Dental insurance
• Flexible schedule
• 401(k)
• Paid time off
• Tuition reimbursement

Schedule:

• 8-hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent

Experience:

• Credentialing: 1 year (Required)
• Computer Skills: 3 years (Required)
• Physician Credentialing: 1 year (Required)

Work Location: Remote

Job Type: Full-time

Pay: $18.00 - $22.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• Do you reside in one of the following states: AZ, NV, TN, TX, WA?

Location:

• Edinburg, TX (Required)

Work Location: Remote