Credentialing Specialist

Greenfield Rehabilitation Agency/Rehab Resources•Brookfield, WI

3d•Hybrid

About The Position

Exciting Opportunity: Join Our Talented Team as a Credentialing Specialist! Are you ready to make a difference in people's lives while enjoying a work-life balance? Rehab Resources & Greenfield Rehabilitation is looking for a dedicated Credentialing Specialist to join our dynamic team and help us continue providing exceptional physical, occupational, and speech therapy services to patients of all ages, from pediatrics to adults. At Rehab Resources/Greenfield Rehabilitation, we pride ourselves on our core values of Agility, Integrity and Community. We offer a supportive work environment where you’ll feel empowered to make an impact, all while enjoying a work life balance hours and a rewarding career. Hours: Monday to Friday, 8:00 AM - 4:00 PM CST. The role is open to a hybrid schedule (a combination of remote and in-office work) after the probationary period. Position Overview As a Credentialing Specialist, you’ll be an essential part of our operations. You’ll manage the credentialing and enrollment process for government and commercial payers, ensuring a smooth experience for our providers. From initial enrollments and CAQH application monitoring to revalidation processes, your role will involve working closely with insurance provider relations, representatives, CAQH, and our internal team to resolve any issues that arise. Why Choose Rehab Resources/GRA? · Therapist-Owned & Operated: We are therapist-owned, committed to seamless operations for our pediatric therapy services. · Core Values: Agility, Integrity, and Community are at the heart of everything we do. · Competitive Pay & Benefits: Enjoy comprehensive health insurance, PTO, sick time, 401K with matching, flexible schedules, and much more!

Requirements

Proficiency in Excel, Word, and Outlook
Strong ability to multitask and take ownership of processes
Self-motivated and able to work independently
Tech-savvy and comfortable navigating multiple computer systems and screens
Ability to perform under pressure in a fast-paced environment with tight deadlines
Experience with Medicare and Medicaid Provider enrollments, including revalidations
Familiarity with insurance websites (e.g., CAQH, Waystar)
Knowledge of NCQA standards
At least 18 years of age.
High school diploma or equivalent.
Advanced training in medical credentialing as noted above

Nice To Haves

Understanding of the 1500 Claim Form
Experience with Clearing House systems, such as Waystar
Medical billing experience
Familiarity with credentialing software platforms
Credentialing certification (CPCS) is a plus, but not required

Responsibilities

Manage Credentialing & Enrollment: Oversee the initial provider enrollment, CAQH monitoring, and revalidation processes for both government and commercial payers.
Collaborate for Success: Work with insurance provider relations, representatives, CAQH, and our internal team to ensure seamless enrollments and resolve any issues that arise.
Multitask & Problem Solve: Navigate multiple systems and tasks simultaneously, ensuring accuracy and timeliness in all processes.