Certified Provider Credentialing Specialist

1 month ago


Tampa, Florida, United States Circle Medical Full time
About Circle Medical

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Our medical practice and underlying technology have pioneered how people find and receive care.

Job Summary

We are seeking a Certified Provider Credentialing Specialist (CPCS) to join our team. As a CPCS, you will serve as a subject matter expert regarding healthcare regulatory requirements across all 50 states and support the Director of Compliance & Policy in the continued development and operation of the credentialing and licensure program.

Key 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
• 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

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

What We Offer

In alignment with our values, Circle Medical has transparent salaries based on location, output levels, and options to trade cash for stock. This is a full-time, salaried position with an annual compensation of $64,500 - $65,700 USD plus generous vacation, full medical/dental benefits, and 401K. Additional benefits include flexible vacation, eligibility after 90-days, 10 annual paid Holidays, $500 annual education and development reimbursement, Medical, Dental, Vision benefits, Life & additional supplemental coverage options, and 401K + Company Matching Program. Circle Medical is an equal-opportunity employer and affirmatively seeks diversity in its workforce.

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