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Credentialing Coordinator - Remote

Role overview

Qualifications

  • Bachelor's degree or equal work experience is preferred
  • Two years plus experience in provider credentialing within the managed care, hospital, or long term care environment
  • Proficient with Microsoft Office applications and a willingness to learn advanced computer software
  • Experience with CAQH/NCQA guidelines is preferred

Responsibilities

  • Facilitates the acquisition of applications from payers, evaluating application requirements and forwarding applications and instructions to territory operations
  • Reviews completed applications to ensure compliance with NCQA and other regulatory and license requirements
  • Maintains database of each health plan's credentialing requirements including ongoing credentialing maintenance requirements
  • Handles correspondence with payer including updates, mailings of applications, and completed executed agreements

Key facts

Hard skills

Other skills

  • Microsoft Office
  • Report Writing
  • Social Skills
  • Detail Oriented

About the company

Powerback logo

Powerback

  • Hospitals & Health Systems
  • XLarge
  • 5,001–10,000
Powerback is a new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an empowered approach to achieving your full potential by providing integrated and individualized solutions. Our reimagined approach to rehabilitation connects directly to the patient experience, which is centered on transforming the road to recovery for everyone and helping patients get their power back. It’s patient-centered care that provides a sustainable way of feeling better, moving better, breathing better, and living better.

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Job description

Overview:

This is a Remote Position - Can Live Anywhere in the US

At Powerback, we're on a mission to improve lives. As the leader in physical, occupational, speech, and respiratory therapies, we help older adults stay active and thrive while providing essential therapy for children at home and in school.

With over 38 years of trusted service, our reach spans skilled nursing centers, assisted and independent living facilities, outpatient clinics, and home-based care. We're proud to deliver personalized care exactly where and when it's needed most.

Join an industry-leading team that restores hope and makes a lasting impact. If you're passionate about making a meaningful difference and want to be part of the future of rehabilitation and wellness, Powerback is the place for you.

Why Powerback?
  • Benefits: We offer Medical, Dental, and Vision plans to Full-Time team members. We offer Dental and Vision to Part-Time team members.
  • Paid Time Off: We offer generous paid time off to Full-Time and Part-Time team members.
  • Support for New Grads: Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn from the best in the field.
  • Continuing Education: Keep growing with free CEUs through Medbridge.
  • H-1B Visa & Relocation Assistance: We support Visa or Green Card sponsorships, plus our Journey Travel Program lets you work across the U.S. with the security of a full-time role.
  • Perks at Powerback: Enjoy exclusive discounts on Wireless/TV, Home/Auto/Renters and Pet Insurance, Childcare, Eldercare, and more. Earn rewards through our PowerZone Employee Recognition Program, and expand your expertise with our Clinicians in Action professional development program
Responsibilities: The Credentialing Coordinator is responsible for coordinating activities associated with credentialing or re-credentialing therapists for health plans according to plan specifications, in conjunction with the territory operations staff. Included in these activities are researching payer credentialing requirements, the submission of completed payer applications and re-applications, initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Provides feedback to reduce errors and contribute to the development of credentialing policies and procedures. 1. Facilitates the acquisition of applications from payers, evaluating application requirements and forwarding applications and instructions to the territory operations to coordinate completion by therapists.
2. Reviews completed applications to ensure compliance with NCQA and other regulatory and license requirements; assists therapists with application completion and provides guidance where necessary.
3. Maintains database of each health plan's credentialing requirements including ongoing credentialing maintenance requirements, i.e. renewal requirements.
4. Maintains provider database consistent with NCQA standards.
5. Handles correspondence with payer including updates, mailings of applications, and completed executed agreements.
6. Prepares accurate and timely reports for internal staff.
7. Interfaces with senior management, vendors, IS, and operations.
8. Performs other duties as assigned. Qualifications: 1. Bachelor's degree or equal work experience is preferred.2. Two years plus experience in provider credentialing within the managed care, hospital, or long term care environment.3. Proficient with Microsoft Office applications and a willingness to learn advanced computer software.4. Experience with CAQH/NCQA guidelines is preferred.  Posted Salary Range: USD $20.00 - USD $20.00 /Hr.

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