Senior Credentialing Specialist

Working at Axuall

 

At Axuall, we believe technology and humankind don't have to conflict.  For us, the reality is that technology can improve the human condition, advance careers, and positively define the future of work.

 

We are a dedicated group of conscientious technology and social innovators.  We value accountability with a promise to our customers and each other that we will own the outcome of our commitments.   We value ethics, respecting the difficulty that abiding by them presents. We value diversity and the impact it has on forward-thinking and innovation.  And, we value fun, because what is work without it? 

 

We offer a wide range of benefits for our team, including comprehensive health insurance, unlimited PTO/vacation days, remote work options, 401(k), fitness stipends, travel-to-work stipends, continuous education support, and family leave.  If you're interested in taking on difficult challenges that matter for humankind, this might be your place.  

About the Senior Credentialing Specialist Role 

 

This person will lead and conduct our auxiliary Credential Verification Organization (CVO) services, as well as provide advisory and quality assurance support during product development and testing.  We are seeking creative, organized, and committed individuals who can identify problems, articulate solutions, and work with our team to meet company goals. We are open to different working arrangements including remote and in-office.  Specific functions for this role include:

 

RESPONSIBILITIES:

This list of duties and responsibilities is not all-inclusive and may be expanded to include other duties and responsibilities, as deemed necessary.

  • Completes provider credentialing and re-credentialing processes meeting Joint Commission and NCQA standards.

  • Obtains primary source verification of clinicians’ state licenses, DEA certificates, malpractice coverage, and any other required credentialing documents.

  • Occasionally field support requests from external constituents, including health systems and practitioners.   

  • Conducts quality assurance testing and documentation of Axuall’s credentialing software in accordance with test plans, specifications, and policies.

  • Maintains corporate provider contract files.

  • Sets up and maintains provider information in online credentialing databases and systems.

  • Tracks license and certification expirations for all providers to ensure timely renewals.

  • Ensures practice addresses are current with client health plans, agencies, and other entities.


REQUIREMENTS:

  • 3+ years of previous credentialing experience with at least 2 references required.

  • Advanced knowledge of licensing, accrediting, CMS, NCQA, Joint Commission, and third party payer requirements.

  • Strong oral and written communication skills.

  • Must be able to handle a wide work variety and work in a fast-paced environment.

  • Must be a detail-oriented, organized, self-starter, and have an ability to prioritize workload.

  • Ability to analyze and interpret data and solve practical problems.

  • Must be a self-starter and can work with little supervision.

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