Credentialing Analyst

Schedule

• Monday–Friday, generally 8 a.m.–5 p.m., with some flexibility.

Work Arrangement

• A hybrid work schedule is available.

Overview

Responsibilities

• Develop enrollment materials and processes, assist with applications, and track enrollment with insurance companies, Medicare, and Medicaid.
• Monitor provider licenses and re-credentialing; coordinate information gathering, registration, and certification processes with staff and agencies.
• Manage credentialing and re-credentialing for employees, subcontractors, contracted facilities, and licensed or certified healthcare professionals.
• Oversee hospital credentialing for Crisis Specialists and communicate status updates to leadership and Medical Billing staff.
• Maintain accurate credentialing data for billing and reporting in coordination with Medical Billing and CCOs; research issues and make adjustments.
• Perform National Provider Data Bank queries, primary source verification, and compliance screening; prepare for and participate in external audits.
• Handle sensitive information in accordance with organizational confidentiality policies.

Qualifications

• Healthcare provider credentialing experience required; behavioral health credentialing experience preferred.
• Education and experience must collectively provide the skills and abilities needed for the essential functions.
• Flexibility for changing priorities, strong attention to detail, and excellent organization skills.
• Must pass required state background and DMV checks, hold a valid Oregon driver's license, and have a satisfactory driving record.
• Ability to work independently under general supervision and understand HIPAA confidentiality requirements.

Benefits

• Benefits include family medical and dental coverage, long-term disability, a 403(b) plan with 6% match, paid time off, and 11 paid holidays annually.