Credentialing and Payer Relations Specialist
Credentialing and Payer Relations Specialist
Ignite Your Career With CORA!
As the Credentialing and Payer Relations Specialist, you will be responsible for the daily management of payer credentialing relationships. Our ideal candidate has an understanding of credentialing, experience working in a healthcare setting and is computer savvy. This is a full-time position.
Who We Are:
CORA Physical Therapy provides a full range of outpatient services for clients with orthopedic problems, work-related injuries, sport injuries, and neuromuscular and neurological conditions. Our community is built on the passion and experience of clinicians who embrace our commitment to Treating Everyone Right.
What You’ll Love About Us:
• Competitive Pay
• Medical, dental, vision, disability, and life insurance
• Seven paid annual holidays + PTO that grows with time
• Retirement & savings plan
• Career growth opportunities within CORA
• Leadership development: coaching, mentorship, and skill-building activities
• Tuition reimbursement
What You’ll Need:
• 2+ years of experience working within hospital or healthcare setting
• 2+ years credentialing experience (preferred)
• Proficiency with Microsoft Office Suite – Word, PPT and Excel is required
• Strong time management and organizational skills
• Excellent verbal and written communication skills
• Good problem-solving skills with high attention to detail
• High level of personal integrity, reliability and honesty
What You’ll Do:
• Perform the clinic credentialing process in accordance with federal, state and payer guidelines
• Timely and accurately complete initial managed care/commercial credentialing and re-credentialing applications
• Track and follow up on initial application process and re-credentialing clinic applications
• Provide routine follow-up on the status of all pending enrollments and escalate issues to Payer Relations Manager as needed
• Distribute required weekly updates regarding pending payer plans
• Collaborate with payers, therapists and office staff to obtain necessary materials and information to complete clinic credentialing process
• Act as subject matter expert for assigned payers for specific states
• Regularly review changes to payment policies and provider manuals that could potentially effect CORA Health Services, Inc.
• Responsible for staying up to date with credentialing requirements for adding new practitioners and/or new clinics to payer contracts
• Acts as point person for registering legal entities with state Medicaid agencies; researching state requirements for Medicaid agencies in new states
CORA Physical Therapy is an Equal Opportunity/Affirmative Action employer. We are committed to building a team that represents a variety of backgrounds, experiences, and perspectives.