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Credentialing Specialist

Added
3 days ago
Location
Type
Full time
Salary
Not Specified

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Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America’s physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accurate, and more compassionate care.

Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from servingunhoused communitiesin Los Angeles toride-share driversin New York.

Founded in 2015 (YC W15), Akido is expanding its risk-bearing care models and scalingScopeAI, its breakthrough clinical AI platform. Read more about Akido’s $60M Series B. More info at Akidolabs.com.

The Opportunity

Are you driven to build the systems that keep healthcare running seamlessly? As a Credentialing Specialist, you’ll be part of our credentialing/provider enrollment team to ensure providers are credentialed and enrolled quickly and accurately with health plans and hospitals — so patients always have uninterrupted access to care.

Credentialing/enrollment activities on this team include:

  • Filling out provider enrollment applications with health plans, Medicare, Medicaid and hospitals.
  • Following up with health plans and hospitals on submitted applications.
  • Solve complicated credentialing-related issues directly with IPAs and health plans.
  • Maintaining a clean database of provider data and enrollment-related activities in MD Staff.
  • Applying for license renewals.
  • Communicating with providers on credentialing-related updates.

This is a hands-on role where you will work with the Credentialing Supervisor and fellow Credentialing Coordinators to ensure all work is completed in a timely and accurate fashion. If you’re energized by improving processes and building a credentialing function that supports high-quality care, we’d love to meet you!

What You’ll Do

  • Work amongst a team of credentialing/enrollment specialists to deliver accurate, timely, and compliant work - including completing credentialing/enrollment tasks.
  • Process credentialing, re-credentialing, and privileging applications to keep providers active and patient care uninterrupted.
  • Solve enrollment-related issues as they arise, working directly with health plans to get them resolved.
  • Monitor application timelines to prevent delays and resolve escalated issues from staff, clinics, and providers.
  • Maintain high data quality, including both provider data as well as credentialing data, like expiration dates, contact information, etc.
  • Follow SOPs and policies that are designed to streamline workflows and strengthen compliance.
  • Maintain compliance with the state, federal, and payer-specific credentialing requirements.
  • Act as a liaison for external partners, including payers, hospitals, and credentialing verification organizations.

Who You Are

  • Bachelor’s degree in healthcare administration, business, or related field (preferred).
  • 3+ years of experience in provider credentialing.
  • Strong knowledge of NCQA standards, payer requirements, and credentialing best practices.
  • Excellent problem-solving and critical thinking skills, with the ability to resolve escalated issues.
  • Exceptional organization skills, with sharp attention to detail and ability to manage multiple priorities.
  • Strong written and verbal communication and interpersonal skills to collaborate cross-functionally and with external stakeholders.
  • Experience with credentialing software and databases (preferred).

Benefits

  • Health benefits include medical, dental and vision
  • 401K
  • Life insurance
  • Wellness benefit

Location & Specialties hiring:

  • This role is in-person in Pomona Valley.
Hourly pay range

$24

$34 USD

Akido Labs, Inc. is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.

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