Senior Credentialing Associate
At UpLift, we believe mental health is just as important as physical health. We're rethinking the mental healthcare model to make it more accessible. While 1 in 5 Americans struggle with mental health issues, only 40% get care because of barriers like cost, distance, information, and the stigma associated with it. Providers want to meet and support more people—but only 30% of therapists accept insurance because of complex and slow approval systems. UpLift bridges clients, providers, and insurers, so everyone can find great mental health care at an affordable rate. We use technology to deliver personalized provider matches, so clients have the agency to select the right provider for them.
Backed by Redesign Health, B Capital, and more, we have brought affordable and accessible mental health care to clients and are looking for driven and empathetic new team members to help us as we scale to new markets in 2023 and beyond. Our founders and leaders come from other high-growth healthcare startups, such as Cityblock Health, Clover, Oscar Health and hims & hers.
Benefits We Offer
- Remote and flexible working environment: work from anywhere in the US!
- Competitive compensation packages in line with industry standards
- Medical, Dental, and Vision coverage with $0 monthly premium options
- 18 days PTO and 12 paid company holidays
- Bi-annual performance reviews & development plans
- Complimentary One Medical Membership (where available)
- Fully paid parental leave
- Annual “work from home” stipend
About the Job
As our Senior Credentialing Associate you’ll support our growing network of providers. A successful candidate will be responsible for assisting with the credentialing and re-credentialing UpLift’s network of providers. This role reports into the Credentialing & Enrollment Manager and sits on the Operations team.
- Ensures providers are credentialed and enrolled with contracted health plans
- Initiates, maintains and verifies all aspects of the credentialing and re-credentialing applications and process for providers
- Completes and reviews all applications to ensure accuracy and completeness prior to submission
- Performs timely monitoring and following-up with health plan and providers on all applications
- Collects and ensure the confidentiality of all required documentation for each provider
- Maintains up-to-date data for each provider in credentialing databases and online systems; ensuring timely renewal of licenses and certifications
- Tracks license and certification expiration dates for all providers to ensure timely renewals
- Maintains all provider's credentialing files
- Maintains up to date knowledge of insurance health plan requirements for credentialing providers, including delegated credentialing requirements per NCQA
- Creates and maintains CAQH accounts; completing timely attestation as required
- Conducts research and provide summaries as requested for various provider types and health plan entities
- Maintain data integrity in different systems, including pulling data from CAQH & 3rd party credentialing systems and manipulating data based on requests from internal and external stakeholders
- Responds to inquiries regarding the status of provider's application
- Prepares, updates and modifies policies, procedures and processes that relate to credentialing as needed/requested and in collaboration with leadership
- Support delegated credentialing audits and related health plan requests
- Assists the team with other functions as needed/requested
- 2-4 years experience in a credentialing role
- 2-4 years working with CAQH and/or other commonly used 3rd party credentialing tools
- Two or more years of experience in the healthcare field dealing with claims/utilization
- Strong excel skills (i.e. vlookup, index match, pivot tables)
- Strong communication skills, verbal and written
- Strong attention to detail and ability to document processes
- Ability to collaborate cross-functionally and work with other departments in a team environment
- Operational mindset, ability to think about how processes will scale as we grow
- Start-up experience preferred
This role is remote and offers a full-time salary of $70,000-$80,000 plus benefits & equity.