Credentialing, Contracting, & Enrollment Specialist (Part-Time)

Job Description

Job Description

Salary : $23-$28

WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need.

We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.

Join us in our mission!

POSITION SUMMARY

This is a part-time position scheduled to work 24 hours per week.

WHERE YOU’LL WORK

This position is hybrid. You will come onsite to the Garden Grove clinic a few days a week.

WHAT YOU’LL DO

• Maintain strong relationships with health plans, medical groups, and other third-party payors and working effectively with internal / external parties to resolve contract-related operational issues
• Process all aspects of credentialing for healthcare providers within the organization
• Ensure compliance with all regulatory requirements and accreditation standards
• Collect, review, and verify provider credentials, including licenses, certifications, education, and work history
• Maintain contract-related information in an electronic format
• Coordinate with insurance payers to complete provider enrollment applications
• Conduct primary source verification of credentials through various databases and organizations
• Maintain accurate and up to date provider files and databases
• Coordinate with internal departments and external entities to obtain necessary documentation and information
• Ensure business processes are performing within desired standards
• Evaluate that applications are properly verified and uploaded into the online credentialing database
• Work with manager to prepare credentialing and re-credentialing files for accreditation surveys
• Monitor expiring credentials and initiate the recredentialing process in a timely manner
• Provide audit reports and conducting analysis including trend identification, and opportunities for improvement to provide individual and department level performance improvement plan
• Ensure data is accurate, consistent, complete, and valid according to established standards
• Respond to inquiries from providers regarding credentialing status
• Maintain current knowledge of credentialing and auditing trends
• Ensure maximum confidentiality, accuracy, security, and appropriate access of all data and records provides maximum protection from discoverability of all information
• Perform other duties as assigned

WHO YOU ARE

• Ability to meet strict deadlines
• Attentive to details
• Good communication skills
• Knowledgeable in policies, laws and procedures
• Strong computer skills
• Proficiency in database management
• Willingness to work as a team-player
• Good organizational skills

WHAT YOU’LL NEED

• Minimum 2 years of experience in credentialing, contracting, and enrollment within a managed care setting
• Knowledge of credentialing standards, regulations, and best practices
• Knowledge in contract evaluation
• Knowledge in enrollment processes
• Familiarity with credentialing software systems

WHAT YOU’LL ENJOY

• Make an impact : an organization who cares about its employees, communities, and the future of healthcare
• Inclusivity : be a part of a workplace where you not only belong but also can be the best version of yourself
• Growth : opportunities to develop and grow your career with us
• Community : you are encouraged to have a voice, share your opinions, and have individual impact on the business
• Paid Time Off : 12 holidays and up to 3 weeks of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, and reproductive loss
• Work Life Balance : enjoy flexibility to maximize your well-being and success with our hybrid work model
• Medical, Dental, & Vision Benefits : we cover up to 100% of your premium and 50% of your dependents depending on the plan
• Flexible Spending, Health Savings & Dependent Care Accounts
• Life / AD&D insurance funded 100% by Titanium Healthcare
• Supplemental Short-Term Disability
• Employee Assistance Programs
• 401(k) plan

EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve.

We believe that achieving this mission starts with a diverse and inclusive workforce.

Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply.

We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.