Contract Credentialing Analyst - Ambulatory Infusion Clinics (AIC)

Option Care Health•Bannockburn, IL

About The Position

The Contract Credentialing Analyst manages the payer credentialing lifecycle, from initial receipt through submission, for existing and new pharmacies. The analyst independently completes complex credentialing requests, forms, attestations, and audits for providers participating in commercial medical and pharmacy networks. The role also supports payer and internal communication, provider demographic reporting, agreement signature processes, and coordination with departments affected by third-party payer contracts.

Requirements

Bachelor’s degree and at least 2 years of payer credentialing or provider enrollment experience, or a high school diploma/GED and at least 5 years of payer credentialing experience.
Experience completing provider credentialing applications or provider enrollment in the medical field.
Time-management skills, including prioritizing, organizing, tracking details, and meeting deadlines across multiple projects.
Ability to build and maintain excellent internal and external working relationships.
Intermediate Microsoft Word skills, including working with text styles, lists, sections, columns, tables, templates, diagrams, and drawing tools.
Intermediate Microsoft Excel skills, including cell formatting, workbooks and worksheets, range names, cell references, sorting, and auto-filtering.
Attention to detail and ability to manage multiple priorities, meet deadlines, and adapt to changing priorities.

Nice To Haves

Bachelor’s degree and at least 2 years of home infusion and/or specialty pharmacy credentialing experience.

Responsibilities

Complete initial credentialing and re-credentialing applications, provider information forms, enrollment forms, disclosures, and provider attestations for commercial medical and pharmacy networks.
Ensure accurate provider information is submitted and communicate with third-party payers and internal teams to resolve potential non-compliance.
Maintain the internal tracking system for credentialing requests, submissions, and renewals, and proactively submit renewals.
Use internal databases, licensing, accreditation, and internal policies to complete applications.
Identify questions requiring escalation to Legal, Litigation, Risk, Compliance, Clinical, Operations, or Contracting.
Maintain knowledge of state and federal credentialing regulations and contracted plans, networks, and credentialing requirements.
Generate monthly demographic reports for internal customers in a standardized spreadsheet format, identifying recent and upcoming changes.
Complete monthly demographic reports in third-party payer formats, including required information such as out-of-state enrollments, provider types, changes from the previous month, and service areas; review data with payers for accuracy.
Co-manage the department email inbox, assess credentialing or payer needs, respond to inquiries promptly, resolve basic contract questions, and escalate as needed.
Review incoming patient-specific letters of agreement for completion and submission for approval.
Facilitate signatures for third-party payer agreements and selected patient-specific letters of agreement through internal or client e-signature platforms or original signatures.
Review documents and potential revenue impact to determine the appropriate internal signer under company policy.
Complete credentialing or demographic information required in contractual documents.
Maintain working relationships with Operations, Legal, Sales, and other departments involved with or impacted by third-party payer contracts.
Assist with ad hoc projects, requests, and initiatives assigned by management.