Credentialing Specialist II

Credentialing Specialist IIBilling Team Portland, OregonDescriptionSUMMARY At ZoomCare we are working hard to make healthcare easy. Our mission is to deliver innovative, high-quality, convenient healthcare when patients need it. We offer same-day, no-wait visits in urgent care, primary care, and specialty care and we're expanding from our roots in the Pacific Northwest to new markets. We hope you will apply to become part of our dedicated, fast-moving team of superstars! ZoomCare is seeking a Credentialing Specialist II to join our team! The Credentialing Specialist II is responsible for providing support to the Credentialing Team and works to support the goals of the Billing Department. The Specialist II assists in performing all credentialing and recredentialing activities. This role ensures that all ZoomCare’s new and existing provider’s files are maintained and continually kept up to date. ESSENTIAL FUNCTIONS Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done.

Manage credentialing and re-credentialing activities to ensure all ZoomCare provider files, both new and existing, are accurate and up to date.

Maintain credentialing files, ensuring all licenses and certificates are current and completed on time with thorough follow-up.

Review provider credentialing applications, including new applicant credentialing, re-credentialing, and ongoing maintenance of credentials.

Monitor, track, and report credentialing information on a daily, weekly, and monthly basis.

Follow up with providers and insurance to ensure all credentialing applications are received, processed, and files are accurate and current.

Enroll providers in Medicare using the Medicare Identity and Access System and PECOS.

Deliver excellent customer service by communicating effectively with the team, solving problems, and organizing projects.

Analyze data with strong attention to detail and accuracy, prioritizing tasks to work efficiently.

Provide support to Credentialing Specialists I and associates.

Other duties as assigned.

QUALIFICATIONS

Bachelor’s Degree is strongly preferred.

Prior experience in credentialing, provider licensing, or privileging.

Prior experience in Medicare provider enrollment

Advanced understanding of NCQA Standards.

Advanced knowledge of provider licensing processes with regulatory agencies.

COMPENSATION PACKAGE

Medical, Dental, Vision benefits

401K with employer match

Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program

Hourly Pay Rate: $27 - $30 per hour depending on experience

WORKING CONDITIONS

Ability to work at a computer and maintain a stationary position for long periods of time.

Project timelines and work volume / deadlines may often require more than your scheduled hours per week or work outside of regular business hours to complete essential duties of this job.

Exposure to sensitive and confidential information.

ZoomCare is committed to the safety and wellbeing of our employees and patients. Therefore, we require that patient-facing employees receive all required vaccinations, including, but not limited to, Hepatitis B., MMR, PPD, Varicella (Chickenpox), TD/TDAP, and all employees to receive COVID-19 as a condition of employment. Medical and religious exemptions or reasonable accommodations may apply.

Job Category: Billing Team