Credentialing and Licensing Specialist- Medical at The Pill Club
Fort Worth, TX, US
We are a family of medical professionals, women's health advocates, and software engineers on a mission to simplify the process of getting birth control! If you are interested in working at a rapidly growing healthcare startup and want to get in on the ground floor of building a company that’s changing the way birth control is dispensed please consider joining our team! 
 
The Pill Club is expanding, and looking for a full-time experienced Credentialing and Licensing Specialist to initiate and maintain active license and credentialing status for employees in multiple states and health plans. They will work closely with regulatory agencies (i.e.; Medicaid, state boards) and payers to provide forms and supporting documentation to guarantee licenses and renewals are current to continue business operations.

Ideal Candidate Should Be:

 

    • Proficient in current technology, including Google Drive, Microsoft Word/Excel
    • Self-driven and effective at multitasking and prioritizing
    • Detail-oriented
    • Team player and problem solver
    • Strong communicator in sending written emails and making phone calls
    • Knowledge of state and federal regulations and accreditation standards
    • Maintain strict confidentiality of all provider files

Responsibilities:

 

    • Manage processing of enrollment applications for Pill Club’s physicians and/or other medical providers. 
    • Work with internal teams, providers, Medicare and Medicaid to assist in completing the enrollment process for medical providers.
    • Responsible for preparing and submitting enrollment applications for providers and supporting documentation to enroll physicians and groups.
    • Completes enrollment applications for the providers
    • Communicates with Medicare/Medicaid and commercial payers regarding specific enrolling questions and updates profiles accordingly
    • Manage credentialing of Pill Club’s physicians and/or other medical providers.
    • Work with medical providers as well as many healthcare facilities and agencies, educational institutions, state agencies, etc. to verify physician credentials and experience. 
    • Process primary source verification as part of the credentialing process.
    • Responsible for maintaining all aspects of the medical provider credentialing process including initial credentialing, re-credentialing and all continuous credentialing elements.
    • Assist with other department projects as assigned.

Minimum Qualifications:

 

    • Bachelor’s Degree or equivalent experience
    • 3 years of healthcare experience

Desirable Qualifications:

 

    • 3 years of medical credentialing experience
    • 2 years of managed care experience
    • CPCS and/or CPMSM Certification
We are an Equal Employment/Affirmative Action employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected Veteran status, or any other characteristic protected by federal, state, or local law.