Credentialing and Support Specialist
About The Position
Ensign Services, Inc. is seeking an experienced, full-time Credentialing and Support Specialist for its Managed Care Team. The role handles credentialing and re-credentialing across the organization, coordinates and supports compliance for applications, serves as a liaison between affiliated entities and health plan partners, and provides administrative and project support to the Contracting team. The position is remote, with applicants considered only in North Carolina or Florida. The specialist ensures credentialing activities comply with applicable policies, procedures, bylaws, rules, regulations, and accreditation standards. The role coordinates credentialing information and documentation, maintains credentialing and contract databases, works with internal departments and external partners, and performs administrative tasks and special projects. The position requires strong organization, attention to detail, communication, confidentiality, follow-through, and the ability to manage competing priorities with minimal direct supervision.
Requirements
- Strong organizational skills and attention to detail.
- Ability to multitask across multiple markets and facilities.
- Critical-thinking skills to analyze projects or problems and work through them effectively.
- Time-management and work-prioritization skills.
- Professionalism and exceptional interpersonal skills.
- Ability to adhere to strict confidentiality guidelines and demonstrate integrity and discretion.
- Strong written and verbal communication skills.
- Teamwork orientation.
- Ability to follow through on delegated tasks and demonstrate accountability.
- Resourcefulness in problem solving.
- Intermediate to advanced computer skills, including proficiency with MS Office applications (Excel, Word, Outlook, and PowerPoint) and PDF editing.
- Ability to learn new software.
- Results orientation and thorough follow-up.
- Knowledge of commonly used credentialing concepts, practices, and procedures.
- Ability to function independently with minimal direct supervision.
Nice To Haves
- At least 2 years of facility credentialing and contracting experience in senior living, skilled nursing, or a long-term care community.
- Proven track record of managing projects.
- Post-secondary degree.
Responsibilities
- Ensure compliance with applicable policies, procedures, bylaws, rules, regulations, and accreditation standards when processing initial credentialing and re-credentialing applications.
- Process credentialing applications and requirements according to applicable provider regulations and policies.
- Coordinate the timely flow of credentialing information to meet deadlines.
- Coordinate with Legal, HR, and Compliance to verify and document pertinent information.
- Maintain current state licenses, CLIAs, COIs, surveys, and other required credentialing documentation.
- Coordinate and maintain the credentialing management database.
- Represent the facilities and company professionally to health plans and external partners.
- Assist Managed Care Resources and the team with special projects, including contract summaries, the contract catalogue, and market-specific projects.
- Coordinate with the Contract Resource to file and maintain the contract database.
- Provide administrative support, including maintaining meeting notes, filing contracts, and processing the credentialing inbox.
Benefits
- Medical, dental, and vision coverage.
- Company-provided life insurance.
- 401(k) with company match.
- Sick and vacation plans.
- Professional growth and development support through a Learning Management System, training sessions, and seminars.
- May be eligible for a bonus.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
