[Hiring] Credentialing Manager @Icon Health

Role Description

Manage the end-to-end curation and submittal of all provider credentialing and enrollment applications to ensure timely approvals.

• Proactively network, identify and engage key decision-makers to successfully appeal and navigate closed panels.
• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and entity-specific regulations, guidelines, policies, and standards.
• Monitor expiration dates for licenses and certifications, launching timely renewals to prevent service or billing issues.
• Collect and validate documents to ensure accuracy of all credentialing elements; assess completeness of information and qualifications relative to credentialing standards.
• Enter, update, and maintain data from provider applications into credentialing database in accordance with internal policies and procedures.
• Prepare, issue, track, and follow-up on credentialing statuses for efficient, high-volume processing in accordance with applicable standards, established procedural guidelines, and strict timelines.
• Conduct research on updated state and federal regulations and policies.
• Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions.
• Participate in the development and implementation of process improvements for the system-wide credentialing process.

Qualifications

• High school diploma required; associates or bachelor's degree in healthcare administration or a related field is preferred.
• 3-5 years of experience in credentialing or provider enrollment.
• Experienced with multi state, multi payer hybrid (telehealth and in person) A MUST.
• Ability to think creatively to navigate closed panels and proactively anticipate any potential roadblocks.
• Certified Provider Credentialing Specialist (CPCS) is a strong plus.
• Proficiency in database management, Google Suite, and AI-assisted credentialing or license-monitoring tools.
• High attention to detail, strong organizational abilities, effective communication, and strict adherence to data confidentiality.
• Knowledgeable in policies, laws and procedures.

Requirements

• We are always looking for new team members who will add to our company’s DNA and have a strong passion for impact.

Benefits

• Flexible scheduling options (to be discussed in interview).
• Benefit package including medical, dental and vision effective on Day 1.
• Work Location: Fully Remote.