Remote Status: Remote
Credentialing Specialist
COMPANY DESCRIPTION
Unio Health Partners (UHP) is a highly differentiated physician practice management platform with the goal of transforming care delivery across the Western United States. UHP partners with leading physician practices, creating a cohesive, quality-oriented clinical culture and facilitating best practice sharing across the platform. Our affiliated practices gain access to a broader suite of services, providing a meaningful benefit to both physicians and patients. UHP's best-in-class clinical program covers three sub-specialties (urology, gastroenterology, and radiation oncology) and offers numerous ancillary services, including pathology lab, in-office dispensing, and chronic care management. We are led by a highly accomplished management team and provide a full suite of management services to its affiliated practices. UHP is currently affiliated with 182 providers consisting of 119 physicians and 63 advanced practice providers operating out of 54 locations across Southern, Central, and Northern California.
POSITION SUMMARY
The Credentialing Specialist is responsible for assisting in the areas of provider and facility credentialing, provider and facility licensing, and hospital privileging. In addition, this position prepares, submits, and maintains enrollment, credentialing, and recredentialing, documentation for physicians and other healthcare providers. This position will support the flow of patient care by providing excellent and efficient credentialing, and compliance with regulations. Comunication with staff, payors, and patients is paramount in this position, ensuring that the credentialing and provider needs of all departments are met effectively and efficiently.
This is a remote position, and worker location must be within Unio Health Partners authorized states: AR, AZ, CA, CO, CT, FL, ID, IL, IA, NV, NM, OR, SC, TX, VA, WA and WI
What you will be doing
- Prepare, submit, and maintain enrollment, credentialing, and recredentialing documentation for healthcare providers.
- Maintain information in credentialing software, including updating information, tracking expiration dates of licenses or certifications, and ensuring accuracy and confidentiality of data.
- Respond to inquiries and emails, staying up to date on credentialing requirements, and facilitate communication to resolve compliance issues and/ or missing documentation.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains knowledge of current health plan and agency requirements for credentialing providers and hospital requirements.
- Manage provider credentialing for hospitals, IPAs, MSOs, and health plans
- Clearly differentiate and manage:
- Credentialing (provider qualification verification and approval)
- Payer enrollment (network participation, billing, and payment setup)
- Complete and track payer enrollment submissions, including:
- Medicare (PECOS reassignments)
- Medi‑Cal
- Commercial payors
What you will bring to the team
- High school diploma or GED certificate required. Credentialing specialist certification a plus.
- 2+ years of healthcare credentialing and practical experience in healthcare setting.
- Proficient with credentialing systems and portals (e.g., CAQH, PECOS, payor portals, Medallion preferred)
- Hands‑on experience with payer enrollment (Medicare, Medi‑Cal, and commercial plans)
- Demonstrated credentialing experience for providers (physicians and advanced practice providers)
- Strong understanding of the distinction between credentialing and payer enrollment
What we can offer you
- Competitive Salary and Health Benefits (Medical, Dental, Vision)
- Generous time off (start accruing on your first day - no waiting period)
- Paid Holidays
- 401(k)
- Company Discounts
- Collaborative work environment - we want our employees to have a say in how we run our office
- Employee Recognition
Compensation is depending on a number of factors including a candidate’s qualifications, skills, competencies, or experience that may fall outside of the range shown
Pay Range: $25 - $30 per hour
