Email Opening Apply Now Title Credentialing Specialist  Full-Time/Part-Time Full-Time   Exempt/Non-Exempt Non-Exempt   Description A hybrid position in Reno, NV. The purpose of the Credentialing Specialist is to provide oversight and accuracy for data entry of enrollment and post enrollment information into required health plan systems on a daily basis. Credetialing Specialist is responsible for applying, analyzing, organizing, storing and maintaining Provider Enrollment documents and verifying credentials and licensing information is accurate upon enrollment application and roster submissions to all HOPES Payors. The ideal candidate will demonstrate strong aptitude for setting up and keeping meticulous records. There must be a strong attention to detail. The candidate must be extremely organized and possess excellent communication and superb customer service skills. They must be able to communicate effectively with all departments and insurance contacts. They must have the ability to work independently, set priorities and meet deadlines with a strong sense of urgency. This position requires someone who is results oriented, excellent problem solver and has top computer skills. What will you do: Responsible for recording, analyzing, organizing, storing and maintaining incoming documents and information from HR and provider offices. Preliminary provider enrollment verification upon receipt of enrollment applications and accompanying documentation Reviews enrollment applications for completeness and accuracy Queries necessary sources to verify information on applications Maintains accurate and up to date credentialing provider files Data entry into credentialing database Submits provider enrollment applications to all network payors Ensures all provider CAQH, NPI, and state requirements are met and updated annually Submits payor requests for network participation Build knowledge base for payor requirements and forms. Develop working knowledge of payor and policies and requirements Submits updates to payors for address changes and/or provider changes Maintains all payor requirements for credentialing. Works closely with Billing Department to respond to any claim denials or benefit issues related to provider credentialing. Meets all federal and state guidelines when processing applications Follow up and check status of applications with payers Requests and files applications, enrollment documents and supporting material. Establishes and maintains detailed provider relations application process (including sample applications), specific state requirements, with name, address, and phone number of the contact people at each intermediary for assigned areas Conducts or assists with the investigation and appropriate reporting of adverse or incomplete information. Coordinates credentialing correspondence. Maintains confidentiality of information processed. Monitors and evaluates the center’s relevant employment and credentialing policies and procedures, and make suggestions for improvements, as needed. Are you passionate about helping others and looking to grow your career in a supportive, mission-driven environment? Join one of Northern Nevada's Best Places to Work – Northern Nevada HOPES! At HOPES, we’re more than just a healthcare provider — we’re a team of changemakers dedicated to delivering affordable, high-quality medical, behavioral health, and support services to everyone in our community. Purpose-Driven Work Be part of a team that’s transforming lives every day. Your work will directly contribute to improving health outcomes and building a stronger, healthier Northern Nevada. People-First Culture At HOPES, every team member is encouraged to bring their unique talents and perspectives to the table. Collaboration and innovation are at the heart of everything we do. Career Growth & Development We invest in your future by offering a mentorship program, leadership and soft-skills training, networking opportunities, and support for continuing education. Exceptional Benefits 100% employer-paid health insurance Life insurance options 3 weeks of PTO in your first year 12 paid holidays annually Paid Parental Leave (after 12 months) 24/7 Employee Assistance Program Click HERE to view a full list of benefits   Position Requirements * Due to real and potential conflicts of interest that exist when HOPES Behavioral Health providers render services to their coworkers, it is HOPES’ policy (Policy HR0005) that HOPES employees may not access HOPES Behavioral Health Services. For the same reason, current Behavioral Health patients/clients cannot be employed by HOPES. Accordingly, you hereby acknowledge and understand that if you are receiving services from a HOPES Behavioral Health provider at the time you are offered and accept employment with HOPES, you have the option of rescinding your acceptance of employment or finding a new behavioral health provider outside of HOPES before starting employment with HOPES. Bachelor’s or Associate degree in Education, Business, Healthcare, Communications, or Public Health or equivalent provider enrollment experience in a health care setting preferred. Experience with Data management, technical knowledge of regulatory requirements for Provider Credentialing & Enrollments preferred. Medical office, Healthcare and/or Community Health Center experience is preferred. Experience with provider credentialing and enrollment databases (i.e. CAQH, NPPES, and PECOS) is preferred. Knowledge of Microsoft Office applications including Word, Excel and PowerPoint. Prioritizes work duties and plans work schedule accordingly. Superior level of professionalism, communication and interpersonal skills. Ability to manage multiple priorities and serious attention to detail.   About the Organization Northern Nevada HOPES is a nonprofit community health center operating two clinics and a transitional housing community in the heart of Reno, Nevada. Our one-stop-shop integrated care model helps us meet our patients where they're at and make medical and behavioral health care more accessible to medically under-resourced populations. Services we offer include adult and pediatric primary care, chronic disease management, nutrition services, behavioral health counseling, substance use counseling and treatment, case management, on-site pharmacies, and more! We accept most insurance plans, including Medicare and Medicaid, and offer discounted services for uninsured patients, so anyone who needs care can access our services. HOPES is a proud member of the Northern Nevada Best Places to Work Hall of Fame, as well as a recipient of the Best Places for Working Parents award and the Candid Platinum Seal of Transparency for nonprofits. Northern Nevada HOPES is a Federally Qualified Health Center and Patient Centered Medical Home. We are a Drug-Free Workplace and utilize E-Verify to confirm work eligibility.   EOE Statement Northern Nevada HOPES is an Equal Opportunity Employer. We prohibit discrimination on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, parental status/pregnancy, national origin, age, physical or mental disability, genetic information, or veteran status in all employment practices.   Salary Range $21.75 - $27.20 per hour   This position is currently accepting applications. 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