Credentialing specialist [h1.location_city]
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Credentialing specialist • ontario ca
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[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]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. 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). Health benefits include medical, dental and vision 401K Life insurance Wellness benefit This full-time role is in-person in Pomona.
Job Description
Job Description
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 serving unhoused communities in Los Angeles to ride-share drivers in New York.
Founded in 2015 (YC W15), Akido is expanding its risk-bearing care models and scaling ScopeAI, 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
Who You Are
Benefits
Location
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.