Certified Provider Credentialing Specialist

ABOUT US

Circle Medical is the fastest-growing telemedicine provider in the US and has seen incredible growth of over 100% per year over the past three years.

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Built by top-tier physicians, engineers, and designers, our medical practice and underlying technology have pioneered how people find and receive care.

More about us can be found on our website!

DESCRIPTION

We are looking for a Certified Provider Credentialing Specialist (CPCS) who will report to the Director of Legal & Regulatory Compliance. As we continue to grow, we are constantly searching for exceptional talent to be a part of our team. This position is hiring remotely in the following states: Florida or Texas.

As the Certified Provider Credentialing Specialist (CPCS) you will serve as a subject matter expert regarding healthcare regulatory requirements across all 50 states and will support the Director of Compliance & Policy in the continued development and operation of the credentialing and licensure program. In addition, you will monitor the credential and licensure status of our providers and be proactive in having them renewed before their expiration date and provide credentialing support and leadership.

WHAT YOU’LL DO

• Track credentialing and licensing status for our providers
• Implement and manage an effective credentialing and licensure program
• Lead and monitor all credentialing, re-credentialing, and provider enrollment processes
• Maintain a database of provider certifications and renewal dates
• Confirm that provider credentials match the requirements of their job
• Help full-time providers apply for or renew credentials which may include finding test dates and locations, identifying CME requirements, or submitting applications and payments on their behalf
• Ensure staff coordination and administration of the credentialing and licensing process for certified staff and providers
• Assist with cross-state licensure process
• Review, analyze and create practitioner credentialing applications, privileging forms, and standardized communications in an effort to improve communication and compliance
• Identify and communicate all concerns regarding practitioner credentialing and enrollment to appropriate parties; follow up when necessary to ensure affected parties and departments are notified of concerns in an appropriate time frame
• Monitor for provider sanctions and collaborate with appropriate teams to action accordingly
• Develop and review company policies
• Communicate with government agencies
• Other duties as assigned by management

WHAT YOU’LL BRING

• 5+ years of credentialing experience with medical staff
• CPCS or CPMSM certification
• Proficiency in using credentialing software and databases.
• The ability to think logically and analytically to problem-solve on a daily basis.
• Have emotional intelligence and the ability to possess self-awareness and base decisions on your analysis of facts.
• Strong time management and prioritization skills to make sound business decisions.
• In-depth knowledge of the clinical, healthcare, and telemedicine standards, regulations, and medical credentialing and privileging procedures and standards.
• Excellent communication skills; written, verbal, as well as auditory
• Familiarity with healthcare, telehealth, and regulatory terminology.
• Professional integrity to adhere to professional confidentiality standards in accordance with HIPAA, legal, ethical, and company policies
• Critical thinking skills to exercise sound independent judgment and discretion in applying departmental policies and procedures while handling confidential medical staff, risk management, and peer review information.

WHAT WILL GIVE YOU AN EDGE

• Proven track record with other startups or VC-funded companies
• Experience in healthcare & health-tech environments
• Bachelor's degree in business, finance, or a related field preferred
• Experience working remotely