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Credentialing & Licensing Specialist

4 months ago

Austin, United States TeleMed2U, Inc. Full time

**Credentialing & Licensing Specialist**

**Job Title**: **Credentialing & Licensing Specialist**

**Entity**:TeleMed2U, Inc.

**Location**: Roseville, CA

**Reports To**: Director of Credentialing, Contracts & Billing Services

**Direct Reports**: None

**Classification**:Full Time, Exempt

**Mission Statement**
- To bring specialty care to everyone and utilize technology to deliver quality care and better patient outcomes. _

**Company Overview**

TeleMed2U is a forward-thinking multi-specialty brand with a mission of brining specialty care to everyone including individuals, providers, and organizations. Our people are our biggest asset who lead the way in making Specialty care more accessible and affordable every day for Americans nationwide. We are an ambitious brand, growing fast to become a household name for Specialty care across the US and constantly need talented people to make it happen. If you are passionate about digital health, helping patients and want to make a difference in healthcare then consider TeleMed2U as the next chapter in your career.

**About The Position**

**Credentialing & Licensing Specialist Job Responsibilities**:

- Supports the TeleMed2U Provider Network’s credentialing process for all TeleMed2U clinical providers, in accordance with NCQA, URAC, Joint Commission, delegated contracts and CMS accreditation standards, Federal and State laws, and TeleMed2U’s policies.
- Coordinates the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
- Assist providers through licensing process
- Maintains, assists in renewing and tracks license and certification expiration for providers

**Payer Enrollment Responsibilities**:

- Manage CAQH profiles for TeleMed2U’s Provider Network.
- Prepare and submit spreadsheets to health insurance plans to ensure provider participation.
- Update various databases to ensure proper tracking of enrollments and update requests.
- Maintain necessary records of outstanding submissions and requests.
- Coordinate all managed care credentialing activities to ensure provider participation status.
- Credentialing activities require substantial contact with outside agencies
- Maintain necessary logs, lists, records, and current documentation required for physician/provider credentialing and re-credentialing.
- Verify physician/provider information for managed care plans including communication with health plan representative and other staff as necessary.
- Follow-up with managed care companies to ensure expedient credentialing.
- Remains current on policies affecting provider enrollment credentials & delegated clients/payers.

**Credentialing & Licensing Specialist Qualifications/Skills**:

- Excellent verbal and written communication skills
- Experience in healthcare industry credentialing
- Ability to multitask and work independently
- Excellent attention to detail

**Education/ Experience Required**
- 1-3 years of experience in licensing and credentialing preferred
- High school diploma
- Bachelor’s degree preferred or equivalent past medical office experience
- Medicare and Medicaid enrollment experience preferred

TM2U is an Equal Employment Opportunity (EEO) employer and does not discriminate in any employer/employee relations based on race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran’s status or any other basis protected by applicable discrimination laws.

Pay: $19.00 - $23.00 per hour

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift
- Monday to Friday

Work Location: Hybrid remote in Austin, TX 78758