Credentialing and Enrollment Specialist 100% remote

Who We Are: 

Vori Health is an award-winning, nationwide, virtual-first, musculoskeletal medical practice focused on evidence-based care that treats the whole person. Using a unique care model to help patients find the best path forward, Vori Health connects patients to a trained care team that includes a nonoperative physical medicine physician, a health coach navigator, and a physical therapist who manage the initial patient assessment and then work to coordinate all aspects of care. We are on a mission to empower humanity to lead a healthier life.  

The Credentialing and Enrollment Specialist will be responsible for ensuring that our clinician pool has all the appropriate credentialing needed to serve Vori Health members in their assigned regions of practice. The role will entail: Initial Credentialing including Primary Source Verifications. Driving and maintaining a detailed database of enrollment applications and updates. Maintaining and setting up the clinician's CAQH accounts. Creating and owning the Medicaid Portals. Administrative work such as; distributing mail, monitoring tasks, and daily reporting. This individual will also work with the clinical team to ensure that all appropriate documentation and requirements are completed accurately and will also work with the billing/RMC team for denials or tasks related to credentialing. 

This is a flexible part time (20-30 hours per week) temp to hire position.

What You’ll Do: 

• Essential Functions: 

  •  Process Credentialing applications including submitting and receiving Primary Source Verifications.  

  •  Responsible for submission of credentialing applications, recredentialing applications, as well as credentialing updates and changes as needed, in a timely manner with minimal defects/delays and maximum efficiency.  

  •  Ability to follow the internal process for completing and submitting applications/revalidations.  

  •  Serve as initial and final reviewer of all applications to assure compliance with each state entity’s specific requirements and file the applications or other required compliance related documentation to appropriate entities.  

  •  Manage internal databases, as well as CAQHs and Insurance Portals, for Vori Health clinicians to ensure accuracy. 

  •  Regularly report out to leadership on status of applications and notify of any blockers.  

  •  Support the department with administrative duties and be the immediate contact for the clinicians.    

• Supervisory Responsibilities: 

  •  N/A 

• Perform other projects and duties as assigned 

Who You Are: 

• Required: 

  •  Minimum 3 years’ experience in licensing/credentialing in a provider setting with knowledge of Delegated Credentialing 

  •  Expert in CAQH, creating and maintaining accounts 

  •  Deep understanding of clinical credentialing nuances across multiple states  

  •  Proficient in Medicare/Pecos and able to maintain Medicaid Portals 

  •  Ability to work with RCM team to rectify credentialing related denials and the CS team for scheduling 

  •  Excellent communication and reporting skills 

  •  Knowledge of Medallion or Click-Up a plus 

  •  CPCS and/or PESC certifications a plus   

• Nice-to-Haves: 

  •  Authorized or able to provide required documents to work in United States or Canada. 

  •  Comfort working within an environment of rapid pace, high uncertainty, and constant change  

  •  Outstanding written and spoken communication skills across various channels and groups and managing team conflict  

  •  Ability to maintain attention to details while also seeing the big picture   

  •  Experience working closely with clinical teams to accomplish shared goals and drive positive collaboration    

  •  Graceful at managing expectations while pushing for continuous improvement 

• Work authorization/security clearance requirements: 

  •  Authorized or able to provide required documents to work in United States or Canada. 

• Physical Requirements/Work Environment: 

  •  Remote work environment.

    •  While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard. 

    • Specific vision abilities required by this job include close vision requirements due to computer work. 

Benefits Notice: This position is part-time and temporary in nature. As such, it is not eligible for benefits, including health insurance, paid time off, or retirement plan participation.  However, there may be an opportunity to continue in this role or increase hours in the future, which could make the position benefits-eligible, depending on company needs and employee performance.

EEO Statement: 

Vori Health is an Equal Opportunity Employer. We are committed to a work environment that supports, inspires, and respects all individuals without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.