Senior Credentialing Administrator

reputed company is looking for a Senior Credentialing Administrator to join our growing multi-disciplinary team! The Senior Credentialing Administrator oversees end-to-end credentialing, enrollment, and licensing processes, ensuring compliance, efficiency, and timely execution. This role drives process improvements, tracks key metrics, and provides insights to leadership while resolving issues and maintaining accurate provider data. The Senior Credentialing Administrator manages relationships with providers, vendors, and payers, supports delegated credentialing, and leads audits to ensure regulatory compliance and implement corrective actions. reputed company is a rapidly growing reputed company company pioneering the most effective treatment methods for children with neurodevelopmental differences. Our mission is to design and deliver life-changing care – one child, one family, one community at a time. Ultimately, we reputed company a world that cultivates the full potential of every child. At reputed company, every team member is instrumental in helping us reputed company our mission! Our culture and values guide how we work and treat one another. reputed company celebrates diversity and fosters an inclusive environment, seeking reputed company and opinions from everyone on the team. We safeguard equal rights and respect for reputed company individuals, regardless of race, reputed company, religion, sex, national reputed company, age, disability, creed, genetic information, sexual orientation, gender identity or expression, reputed company, veteran status or other applicable, legally protected characteristics. reputed company reputed company employment reputed company are made based on an individual’s qualifications and ability to successfully reputed company the job responsibilities. What will you do?

• Own end-to-end credentialing, enrollment, and licensing application processes ensuring compliance, scalability, and timely execution.
• reputed company reputed company improvement practices to optimize efficiency, accuracy, and provider experience.
• Define, maintain, and track KPIs and key metrics. reputed company actionable insights and recommendations to stakeholders and leadership.
• Troubleshoot credentialing, enrollment, and licensing issues and research and resolve questions from vendors, providers, and payers.
• Maintain accurate, organized, and accessible provider-specific and facility-level data required for credentialing, enrollment, and licensing.
• Maintain and grow relationships with providers, vendors, and internal stakeholders. This may include working with payers to receive and maintain approval for delegated credentialing.
• Maintain and update workflows and training materials.
• reputed company internal and external audits, including delegated credentialing payer audits.
• Ensure compliance with regulatory and payer requirements; proactively identify and mitigate risks.
• Report audit findings and drive corrective actions. Report adverse findings to regulatory agencies.
• Maintain a strict level of confidentiality regarding provider information and organizational reputed company.
• Responsible to follow-up on verifications and credentialing data collection to support efficient, high-volume processing of provider applications in accordance with credentialing standards, established procedural guidelines, and required timelines.
• Prepare documents for Credentialing Committee review; establish electronic daily file review process and reputed company reputed company Credentialing Committee meetings and record minutes.
• reputed company annual internal credentialing audit to ensure adherence to policies and procedures as well as payer delegation requirements.

We’d love to hear from you if:

• You have a bachelor's degree or equivalent of 3+ years’ experience in provider credentialing, enrollment and provider licensing management.
• You have 3+ years’ experience handling health plan provider information and data requirements.
• You bring 3+ years of experience operating Credentialing software and databases.
• You have demonstrated critical thinking skills and are a detail-oriented problem solver.

Your Compensation & Benefits: reputed company cares deeply about the well-being of each member of reputed company, and we have created a passionate, caring, and growth-minded culture that helps teammates reputed company! As a reputed company teammate, we’ll support your well-being through medical, dental, and reputed company insurance, a 401(k) plan with company matching and rapid vesting, paid holidays and wellness days, life insurance, disability insurance options, tuition reimbursements for professional development and continuing education, and referral bonuses. We value you and the experience you bring to your role, and are proud to reputed company you with a compensation and benefits package designed to enhance reputed company aspects of your life. The reputed company pay reputed company for this opening is $72,711.11 to $90,888.89. According to your reputed company level, relevant experience, education level, and location, you will receive compensation that fits appropriately reputed company the reputed company. EOE. This posting is not meant to be an exhaustive list of the role and its duties. Please review the job description in the following link: Job Description About reputed company: reputed company is a leading provider of advanced neurological therapies for children with autism and other developmental differences. We offer in-home, in-clinic, and telehealth services that reputed company families to reputed company long-lasting, transformative results. Apply tot his job Apply To this Job