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Credentialing Associate
Bicycle HealthCredentialing Associate enrolling healthcare providers with insurers and government programs for Bicycle Health’s opioid-use-disorder telemedicine practice. Managing payor issues, revalidations, records, and CAQH attestations.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in credentialing and payor enrollment processes, including managing contracts with private and public payors. Proficient in maintaining compliance with enrollment requirements and deadlines while ensuring accurate documentation and reporting.
Highest-signal resume keywords
Credentialing ExperiencePayor Enrollment ManagementKnowledge of State MedicaidPECOS System ProficiencyAttention to Detail
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CredentialingPayor EnrollmentContract ManagementRevalidation TrackingDocumentation ManagementReportingCAQH Profile Re-attestationMedicare KnowledgeManaged Medicaid Care KnowledgeInsurance Carrier Familiarity
Soft Skills
Organizational SkillsPrioritization SkillsTeam CollaborationReceptiveness to FeedbackContinuous Improvement Mindset
Tools & Technologies
PECOS SystemVideo Conferencing ToolsRemote Work Setup
Certifications & Qualifications
Payer Enrollment CertificationHealthcare Administration Certification
Industry Keywords
Private Health PlansPublic PayorsManaged Care OrganizationsEnrollment RequirementsReimbursement Processes
About the role
Key responsibilities & impact- Ensure all necessary documents (licenses, contracts, tax information, etc.) are submitted to payors and are current to meet enrollment and revalidation requirements
- Act as the point of contact for resolving enrollment issues, such as rejections, delays, or discrepancies, by communicating directly with payors
- Monitor and track revalidation deadlines for providers to ensure timely re-enrollment and prevent disruptions in reimbursement
- Maintain records and provide reports on the status of payor enrollments, including completed, pending, and rejected applications
- Ensure timely re-attestation of CAQH profiles
- Maintain regular and predictable attendance
- Perform all other duties as assigned
Requirements
What you’ll need- Minimum 1-3 years experience in credentialing and payor enrollment, including maintaining in-network contracts/enrollments with private and public payors
- Knowledge of State Medicaid, including Managed Medicaid Care Organizations, Medicare, commercial/private health plans, and insurance carriers
- Knowledge of PECOS system
- Experience working with major payors such as UnitedHealthcare, Aetna, Cigna, and Blue Cross Blue Shield
- Strong attention to detail and accuracy
- Excellent organizational and prioritization skills
- Team-oriented with a collaborative mindset
- Receptive to feedback and continuous improvement
- Certification in payer enrollment, healthcare administration, or a related field is a plus
- Experience working from home is preferred
- Consistent access to a private work environment with high-speed internet and professionally appropriate surroundings for frequent video conferencing
- Workstation setup conducive to remote work needs
Benefits
Comp & perks- 3 Weeks PTO + 8.5 days of additional sick time + 10 paid holidays
- Paid parental leave
- 100% Employer Paid Medical, Dental, and Vision Insurance
- Employer Paid STD & LTD
- 401k
- $50 monthly Remote Work Stipend