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Credentialing Specialist
- New York, New York, United States
- New York, New York, United States
Über
Manage provider enrollment & credentialing: Lead the full credentialing lifecycle for new and existing providers and practice locations — including Medicare (PECOS), Medicare Advantage plans, and other payers.
Maintain provider data: Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
Optimize workflows: Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices.
Develop SOPs: Write, maintain, and iterate standard operating procedures for credentialing functions and integrate them into operational practice.
Monitor compliance: Track credentialing status, re-credentialing deadlines, notices, and plan requirements to ensure uninterrupted provider participation in payer networks.
Communicate across teams: Partner with internal stakeholders — including Clinical Operations, Payer Strategy, and Provider Growth — to align priorities and share updates on credentialing progress and blockers.
Provider support: Serve as a credentialing point of contact for providers and internal teams, answering questions and coordinating documentation submissions.
What We're Looking For
Credentialing experience: 3+ years of direct experience in provider enrollment and credentialing, including both group and individual provider enrollments.
PECOS wizard: You have extensive experience working with PECOS enrollments, I&A, and request for corrections – this is a must.
Medicare Advantage applications: Prior work with Medicare Advantage health plans and credentialing requirements.
Tracking and project management tools: Comfortable learning and using tools such as Airtable, credentialing automation software, and common office/productivity apps.
Detail-oriented & organized: You have impeccable attention to detail, stay organized, and meet deadlines in a fast-paced environment.
Process mindset: Experience building SOPs and improving operational workflows.
Collaborative communicator: Able to work cross-functionally and communicate clearly with internal teams and external partners.
Why Sailor Health?
Mission with impact. Help bring life-changing care to a population that's too often overlooked.
Remote-first team. Enjoy the flexibility of remote work while staying closely connected with a thoughtful, collaborative team rooted in purpose.
Growth and ownership. Be part of a small, agile team where you'll take initiative, shape key processes, and grow as we grow.
Make someone's day – every day. Your work helps older adults and their families feel seen, supported, and cared for.
Our Offer to You
Competitive salary
Comprehensive benefits, including medical insurance
Flexible PTO and sick days
Friendliest and most dynamic team culture
If this sounds like you, we'd love to connect. Join us in redefining what it means to age with dignity, connection, and mental wellness.
Sprachkenntnisse
- English
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