DeepWork Portfolio Careers

About the job

Recuro Health is a leading virtual-first care delivery company offering a personalized, holistic, and proactive approach to healthcare. Recuro provides seamless access to various virtual care services, including primary and urgent care, behavioral health, at-home lab testing, and genomics testing. Additionally, Recuro provides a comprehensive suite of supplemental benefits, integrated prescriptions, care management, and care navigation, all available on a unified platform. For more information, visit www.recurohealth.com.

POSITION SUMMARY The Contracting and Credentialing Specialist works directly with the Director of Network Management to initiate and maintain Recuro’s contracts with payors and providers. This role provides support in contracts administration and credentialing as a representative of Wellvia Physicians, P.A with payers in the group’s market areas. This is a remote position.

CORE RESPONSIBILITIES

• Prepare and submit individual provider applications, rosters, and group applications for payer enrollment
• Prepare and submit demographic updates as needed
• Follow up timely to check status of submitted applications
• Maintains open communication with providers, payers, and internal stakeholders to resolve credentialing and enrollment issues related to provider files
• Maintain and organize payor and provider document copies, NPPES/TMB/CAQH/DEA and other required profiles, as well as files that are accessible to internal stakeholders
• Maintain Provider Rosters and EMR/PM systems by tracking payor enrollment and onboarding information
• Prepare special reports, summaries, and/or replies to inquiries by compiling data and statistics from various departmental resources
• Supports Director to ensure legal compliance and adherence to accreditation guidelines
• Collaborate with internal stakeholders to support provider onboarding, credentialing, and payor enrollment
• Support and acts as a backup to Revenue Cycle team members
• Represents Wellspring Physician medical groups to third party payors
• Works with Legal, Finance, Revenue Cycle Management, and other teams to support workable business arrangements that are consistent with Recuro’s contracting goals
• Participates in the development of internal credentialing processes
• Manage strategic relationships with payors
• Comply with all HIPAA rules and regulations
• Other duties as assigned

EDUCATION

• High School or equivalent
• Some College (preferred)

EXPERIENCE

• 5+ years of experience working in payor enrollment and credentialing
• Thorough understanding of managed care insurance products and their financial impacts on payers and providers; understanding of contracting processes and operations required

QUALIFICATION REQUIREMENTS

• Ability to adapt to process improvement changes and evolving deadlines
• Attention to detail
• Exceptional organizational skills
• Proficiency in database management
• Strategic and flexible thinker who assesses situations carefully and delivers scalable recommendations and results
• Strong written and verbal communication skills
• Effective interpersonal skills

TRAVEL REQUIRED:

No travel required.

Successful applicants must be eligible to work in the US (visa sponsorship is not provided at this time) and must be able to pass a pre-employment background test. Recuro Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.