Credential Spec Onboard

Position: Credentialing Specialist – Onboarding – Remote

Monogram Health is seeking an experienced and detail-oriented Credentialing Specialist to support the onboarding functions within our Licensing and Credentialing (L&C) Department. This role is responsible for leading the internal L&C onboarding process for new practitioners, ensuring a smooth transition through licensing, primary source verification, and payor enrollment to practitioners for patient engagement as quickly as possible.

We are looking for a self-directed, remote Credentialing Specialist with expertise in practitioner demographic intake, efficiency, and process automation. The ideal candidate will guide practitioners through each step of the onboarding process, from completing credentialing packets to setting up the necessary accounts for Medicare and CAQH, ensuring all demographic and licensing information is accurate and complete.

This role requires identifying, analyzing, and resolving information discrepancies and timing issues that may impact our organization’s ability to license, credential, enroll, or privilege providers. The specialist will be responsible for maintaining accurate and comprehensive data in credentialing software and shared drives, which may be subject to internal, health plan, and NCQA audits.

The onboarding credentialing specialist identifies, analyzes, and resolves information discrepancies, and time gaps that could adversely affect our organization’s ability to credential, enroll and/or privilege providers. The onboarding credentialing specialist is responsible for maintaining timely, accurate and comprehensive data in credentialing software and shared drives which can be subject to internal, health plan and NCQA audits at any time.

Ideal candidates will have previous experience with large clinical organizations, medical staff offices, third-party payor enrollment, or credential verification organizations in roles such as Intake Specialist, Provider Enrollment Specialist, Credentialing Specialist, or Medical Staff Office professional.

Key Traits for Success: Persistent, detail-oriented, process-driven, accuracy-focused, organized, strategic, and adaptable.

Roles and Responsibilities

Collaborate effectively within a team environment, demonstrating strong teamwork skills
Serve as the onboarding specialist, ensuring seamless transitions to licensing, credentialing and payor enrollment within required timeframes
Communicate with Management, HR, Recruiting and Executive Leadership as needed to advance onboarding in line with escalation processes.
Generate and send appropriate forms and correspondence to practitioners
Collect all necessary signatures and documents to submit complete applications to payors or state licensing boards
Enter practitioner demographics and enrollment data into credentialing software in compliance with MH policies and NCQA standards.
Scan and store all related onboarding documents in the credentialing software
Document and note all critical payor enrollment lifecycle events in credentialing software (ie. Enrollment Documents Received from Practitioner, Application Received by Payor, Requests for Information, Committee Review and Network Approval)
Provide ad-hoc reporting and special projects when requested
Familiar with Medicare Advantage credentialing and telehealth payor requirements
Maintain confidentiality of information and security of credentialing files
Able to take advantage of department training/resources for self-guided learning.
Other duties as assigned

Ideal Qualities

Thoughtfulness: Ensure a positive first experience for onboarding practitioners, contributing to a welcoming and thorough onboarding program
Detail-Oriented: Capture accurate information during onboarding to set the team up for success
Resourcefulness: Utilize resources effectively to very and confirm information, thinking critically to resolve issues
Engagement: Communicate openly and stay connected with the team, contributing to a cohesive work environment

Position Requirements

3 + years in medical staff services or a similar role focused on licensing, payor enrollment or credentialing support experience required
Bachelor’s degree preferred; certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is a plus
Familiarity with credentialing software, proficiency in Microsoft Office applications, particularly Excel and Word Microsoft as well as and Adobe Acrobat and Adobe DocuSign. Proficient with credentialing systems and learns new systems/processes quickly
Skilled in managing multiple application processes simultaneously, ensuring that all submissions are well-documented and on track for completion.
Excellent attention to detail
Ability to research data and draw conclusions.
Ability to manage assigned projects individually, without supervision, and make independent decisions
Consistently meets project deadlines and communicates and projected delays with manager/director in advance of deadlines to ensure business needs are met
This role is volume-dependent, with workload variations based on market expansion and internal business needs. The Specialist will also provide backup support for payor enrollment and internal credentialing as needed. Cross-training will be provided by management

Benefits

Opportunity to work in a dynamic, fast-paced and innovative care management company that is transforming the delivery of kidney care
Competitive salary and opportunity to participate in company’s bonus program
Comprehensive medical, dental, vision and life insurance
Flexible paid leave & vacation policy
401(k) plan with matching contributions

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.

At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.