WINDSOR HTS, IA
This is a remote position.
Job Description
Oversee and manage all provider licensing and credentialing aspects, ensuring compliance with regulatory and payor requirements
Coordinate multi-state license applications, renewals and verifications
Support provider enrollment process with major payors, including Medicare, Medicaid, Medicaid Managed Care Organizations and private insurance companies
Maintain accurate and up to date documentation using the Medallion platform, ensuring timely renewals and meeting compliance deadlines
Manage payor logins and facilitate access for providers and the billing team to ensure smooth claims processing and efficient operations
Collaborate with internal teams to support provider onboarding, transitions and exit processes
Develop and maintain clear policies and procedures for licensing and credentialing requirements
Identify opportunities to improve processes, streamline operations and enhance efficiency
Provide training and resources to providers and staff regarding licensing, credentialing and compliance standards
Generate reports and provide updates to leadership on credentialing and licenses activities
Assist with audits, inspections and any compliance-related inquiries
Performs other duties as assigned
Experience
Minimum of 2 years experience in medical licensing, credentialing or related field
Preferred experience managing multi-state licensing and credentialing processes
Familiarity with major payors, including Medicare and Medicaid, Medicare Advantage Plans and private insurance companies
Strong organizational and communication skills, with attention to detail
Be able to multitask in fast paced environment