Contracting & Credentialing Specialist

TherapistTherapistContractRemote

Location

United States

Posted

15 days ago

Salary

Not specified

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

We're hiring a Contracting & Credentialing Specialist who will be responsible for supporting all credentialing, licensing, and payer contracting activities within the Managed Care Contracting & Credentialing Department. This role ensures MD, APRN, RPSGT, RTT profiles and facilities are appropriately credentialed and licensed (include Rx authority and autonomous practice when applicable), re-credentialed, and contracted in compliance with regulatory, payer, and organizational requirements.

  • Coordinate end-to-end provider credentialing and re-credentialing processes with commercial and government payers, including application submission
  • Prepare, submit, and track credentialing applications through CAQH and payer portals
  • Support payer contracting activities, including data collection, application submission, and follow-up
  • Submit and follow up on licensing activities with multi-state boards and provide update and visibility to leadership
  • Maintain accurate provider credentialing files in accordance with regulatory and accreditation standards (federal, state and local regulations)
  • Monitor credentialing timelines and proactively address delays or deficiencies
  • Serve as a liaison between providers, internal departments, and payers regarding credentialing, licensing and contracting status
  • Maintain credentialing databases and ensure data integrity across systems
  • Assist with audits, reporting, and credentialing (licensing) metrics as requested
  • Support licensing needs guided by the organizations growth
  • Stay current on payer requirements, regulatory changes, and industry best practices
  • Provide administrative and project support to the Senior Manager of Contracting & Credentialing as needed

Qualifications

  • Bachelor’s degree or equivalent experience preferred
  • 3+ years of experience in provider credentialing, licensing and/or managed care contracting
  • Sleep Clinic, Sleep device and Telehealth (multi-state) experience is a plus
  • Strong working knowledge of state boards, CAQH, payer portals, and credentialing workflows
  • Familiarity with ACHC, AASM, CMS, and state regulatory requirements
  • Strong attention to detail, organization, and follow-up skills
  • Ability to manage multiple priorities and deadlines in a fast-paced environment
  • Excellent written and verbal communication skills
  • Credentialing certification (CPCS or CPMSM) a plus

Benefits

  • Meaningful work that directly improves peoples’ lives
  • Be part of an international team across the US, France, Belgium
  • Annual team offsite
  • Comprehensive health benefits (medical, dental, vision)
  • FREE One Medical membership
  • 401(k) with company match
  • 20 days PTO + 10 paid holidays + 80 hours paid sick leave
  • Monthly phone and internet stipend

Compensation

$60,000 - $70,000 depending on experience.

Our Core Values

At Sunrise Group, we keep things clear and simple ✨, value trust and collaboration 🤝, and lead with optimism and compassion 🌞. These values guide everything we do.

Job Requirements

  • Bachelor’s degree or equivalent experience preferred
  • 3+ years of experience in provider credentialing, licensing and/or managed care contracting
  • Sleep Clinic, Sleep device and Telehealth (multi-state) experience is a plus
  • Strong working knowledge of state boards, CAQH, payer portals, and credentialing workflows
  • Familiarity with ACHC, AASM, CMS, and state regulatory requirements
  • Strong attention to detail, organization, and follow-up skills
  • Ability to manage multiple priorities and deadlines in a fast-paced environment
  • Excellent written and verbal communication skills
  • Credentialing certification (CPCS or CPMSM) a plus

Benefits

  • Meaningful work that directly improves peoples’ lives
  • Be part of an international team across the US, France, Belgium
  • Annual team offsite
  • Comprehensive health benefits (medical, dental, vision)
  • FREE One Medical membership
  • 401(k) with company match
  • 20 days PTO + 10 paid holidays + 80 hours paid sick leave
  • Monthly phone and internet stipend
  • Compensation
  • $60,000 - $70,000 depending on experience.
  • Our Core Values
  • At Sunrise Group, we keep things clear and simple ✨, value trust and collaboration 🤝, and lead with optimism and compassion 🌞. These values guide everything we do.

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