Credentialing Specialist

2 weeks ago

Overland Park, Kansas, United States Connect Staffing and Consulting Full time

Credentialing Specialist

Location: Fully Remote (based in Overland Park, KS)

About My Client

My client is a rapidly growing healthcare services organization that delivers onsite dental, vision, hearing, and podiatry care to long-term care and skilled nursing facilities across multiple states. With a reputation for innovation, operational excellence, and compassionate service, they have doubled in size over the past four years while maintaining a customer satisfaction rating above 98%. Their mission is to enrich the quality of life for residents through values-driven care, teamwork, and continuous improvement.

Position Overview

The Credentialing Specialist plays a critical role in ensuring compliance and operational readiness across multiple service lines and states. This position is responsible for managing institutional and individual provider credentialing, contracting, and re-credentialing with commercial, Medicare, and Medicaid payors. Success in this role requires precision, discretion, and the ability to navigate complex regulatory environments while collaborating with clinicians, payors, facilities, and internal teams.

Key Responsibilities

  • Prepare and submit credentialing applications and supporting documentation for provider enrollment with commercial, Medicare, and Medicaid networks.
  • Monitor application status, track progression, and resolve issues with payors to ensure timely approvals.
  • Maintain an accurate, up-to-date database of provider credentials and payer statuses across multiple states.
  • Partner with billing, scheduling, and compliance teams to communicate approvals and address denials.
  • Ensure strict adherence to HIPAA and confidentiality standards.
  • Manage facility credentialing applications and support provider onboarding tasks.
  • Utilize payer portals and CAQH to maintain current provider information.
  • Serve as a liaison with providers and payors to obtain missing information and resolve discrepancies.
  • Stay current on evolving payer requirements and state licensing regulations.

Candidate Profile

  • Minimum 2 years of healthcare credentialing experience (multi-state preferred).
  • Strong background in data management and integrity.
  • Associate's degree preferred; equivalent experience considered.
  • Proficiency in Microsoft Office (Excel, Word, Outlook) with ability to manage large datasets.
  • Exceptional organizational skills, attention to detail, and critical thinking ability.
  • Proven ability to work independently, prioritize effectively, and meet deadlines in a fast-paced environment.
  • Professional communication skills with the ability to collaborate across departments and external stakeholders.
  • Adaptability to frequent changes in payer requirements and operational demands.

Compensation & Benefits

My client offers a comprehensive benefits package designed to support employees and their families, including:

  • Paid Time Off (PTO) and paid holidays.
  • 401(k) retirement plan with company match.
  • Medical, dental, and vision insurance.
  • Company match for Health Savings Account (HSA) and Flexible Spending Account (FSA).
  • Company-paid Employee Assistance Program (EAP).
  • Life and disability insurance.
  • Additional wellness programs and perks.

Working Conditions

  • Fully remote role, with headquarters based in Overland Park, KS.
  • Standard business hours, Monday–Friday, with occasional flexibility required for project deadlines.
  • Substantial time spent working on a computer; minimal exposure to health or safety hazards.

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