We're looking for an experienced, detail-obsessed, self-directed Credentialing Specialist to own our provider credentialing function from start to finish. You will have full ownership of the credentialing lifecycle for a high-volume, multi-site panel of providers. You will also own the billing and clinical functions that touch on credentialing as well.
You'll be credentialing and re-credentialing fully licensed clinicians across 9+
locations, managing relationships with all major Minnesota payers, and keeping a growing panel - currently 100+ clinicians - current, compliant, and billable.
The work is meaningful: when credentialing falls behind, client care is disrupted. You understand that and know how important it is to avoid that.
What you'll own
- Initial credentialing for new providers across all in-network payers - submitting
applications, tracking status, and following up until complete
- CAQH and MCC profile creation, maintenance, and attestation management for all
providers
- Re-credentialing - proactively managing expiration calendars so nothing lapses
- Provider data across CAQH, PECOS, NPPES, and payer portals- accurate, current,
and audit-ready
- Communication with payers, providers, and leadership - clear, timely, and
professional
- Investigation and follow-up of all billing-related credentialing issues
- Reporting on credentialing status, pending applications, and compliance gaps
- Flagging risks early and solving problems before they become billing disruptions
Who you are
You've managed credentialing for a substantial panel of providers (ideally 50+), you know what a clean and consistent credentialing process looks like, and you understand why re-credentialing calendars are not optional. You're organized, you follow-up, and you don't let things fall through the cracks.
You Might Be a Great Fit If You
- Have 3+ years of credentialing experience in a healthcare setting
- Have personally managed credentialing for a panel of 50 or more providers
- Are familiar with Minnesota payers - HealthPartners, UCare, BCBS MN, Medica, UHC, MN Medicaid - or have the demonstrated ability to get up to speed quickly on an unfamiliar payer landscape
- Are comfortable owning a function independently, without daily oversight
- Include the #25 in the subject line of your application email
- Thrive in a remote-friendly, trust-based environment where your results speak for themselves
- Are looking for a primary professional home, not a side client to fit in between
other work
What this role is not
We've learned from experience that this function requires someone whose primary focus is
Not one of several clients in a portfolio. We've gotten clear about what we need, and we'll ask you to be honest and direct about your ability to dedicate full-time hours to our practice.
Benefits
- Flexible schedule and fully remote
- A leadership team that trusts you, doesn't micromanage you, and wants to support you
