Contracting & Credentialing Specialist

48 minutes ago
Full-time
Mid Level
Operations
Sunrise Group

Sunrise Group

Sunrise Group empowers businesses across various sectors, including technology, automotive, and healthcare, by providing innovative consulting services that promote diversity, inclusion, and environmental sustainability.

Internet Software & Services
51-250
Founded 2008

Description

  • Coordinate end-to-end provider credentialing and re-credentialing with commercial and government payers.
  • Prepare, submit, and track applications through CAQH and payer portals.
  • Support payer contracting through data collection, submissions, and follow-up.
  • Submit and monitor licensing activities with multi-state boards, including prescription authority and autonomous practice requirements.
  • Maintain accurate credentialing files and databases in compliance with regulatory and accreditation standards.
  • Monitor timelines, resolve deficiencies, and provide status updates to leadership.
  • Act as a liaison between providers, internal teams, payers, and external agencies.
  • Assist with audits, reporting, metrics, and licensing projects.
  • Stay current on payer requirements, regulatory changes, and industry practices.
  • Provide administrative and project support to the Senior Manager of Contracting & Credentialing.

Requirements

  • 3+ years of experience in provider credentialing, licensing, and/or managed care contracting.
  • Bachelor’s degree or equivalent experience preferred.
  • Working knowledge of state boards, CAQH, payer portals, and credentialing workflows.
  • Familiarity with ACHC, AASM, CMS, and federal, state, and local regulatory requirements.
  • Strong attention to detail, organization, follow-up, and data-management skills.
  • Ability to manage multiple priorities and deadlines in a fast-paced environment.
  • Excellent written and verbal communication skills.
  • Sleep clinic, sleep device, or multi-state telehealth experience preferred.
  • CPCS or CPMSM credentialing certification preferred.

Benefits

  • $60,000–$70,000 annual compensation, depending on experience.
  • Medical, dental, and vision coverage.
  • Free One Medical membership.
  • 401(k) with company match.
  • 20 days of PTO, 10 paid holidays, and 80 hours of paid sick leave.
  • Monthly phone and internet stipend.
  • Annual team offsite and collaboration with an international U.S., France, and Belgium team.

Interested in this position?

Apply directly on the company website

Apply Now

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