Credentialing Specialist - Medical Billing

Gryphon Healthcare

  • Houston, Texas
  • 2 days ago
  • Remote

    Highlights

    The Credentialing Specialist is responsible for managing the credentialing process including verifying qualifications, maintaining compliance with regulatory requirements, and communicating effectively with clients and internal teams. The Credentialing Specialist will collaborate with clients and internal team to address credentialing issues, resolve delays and denials, and maintain accurate records.

    Numbers & Facts

    LocationHouston, Texas (
    Remote
    )
    Websitehttps://www.gryphonhc.com

    Description

    Job Title: Credentialing Specialist
    Location: Remote
    Schedule: Full-Time

    About Gryphon Healthcare
    Gryphon Healthcare is a Houston-based revenue cycle management company serving healthcare providers nationwide. We pride ourselves on delivering results through accountability, transparency, and a hands-on approach, what we call “The Gryphon Difference.” Our team is collaborative, driven, and committed to supporting one another while delivering exceptional outcomes for our clients.
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    Position Summary
    The Credentialing Specialist is responsible for managing the credentialing process including verifying qualifications, maintaining compliance with regulatory requirements, and communicating effectively with clients and internal teams. This position will check the credentialing database every day and review it for upcoming revalidation dates and status updates. The Credentialing Specialist will collaborate with clients and internal team to address credentialing issues, resolve delays and denials, and maintain accurate records. It requires strong analytical and communication skills and comprehensive knowledge of healthcare credentialing and payer enrollment processes.

    Duties and Responsibilities
    • Prepares and submits provider applications to all major payers for in network clients
    • Ensures timely processing of all credentialing requests
    • Verifies primary sources information and ensures that the applications have this correct information as part of the onboarding process.
    • Follow-up on applications daily, weekly, and monthly until completion
    • Working Knowledge of CredentialStream to log and record provider information according to our workflow
    • Works closely with the AR team to resolve ongoing credentialing issues and denials
    • Monitors provider license, DEA and board certification expiration dates and sanctions
    • Assists with new client start-up and group credentialing
    • Communicate with clients about expired documents, payer status, discrepancies with verification findings, and new certifications on a consistent basis
    • Performs provider onboarding with payers for client medical staff
    • Maintains client CAQH provider records
    • Working knowledge of EFT/ERA enrollment for all payers

    Education Requirement
    College degree preferred. 
    High School graduate or equivalent required.  

    Experience Requirement
    2 years of experience in credentialing preferred
    Experience with CredentialStream preferred

    Skills & Competencies
    Ability to manage a diverse workload, prioritize competing demands, and successfully multitask in a fast-paced environment
    Highly organized with strong time management skills and the ability to maintain efficient workflows.
    Demonstrates persistence and resilience in overcoming challenges and achieving objectives
    Possesses strong verbal and written communication skills, with the ability to effectively interact with team members, clients, and stakeholders
    Exhibits exceptional attention to detail, ensuring accuracy, quality, and consistency in all work performed
    Proactive, solutions-oriented mindset


    Work Environment & Physical Requirements
    Remote position
    Ability to work in a fast-paced, high volume and dynamic environment
    Ability to sit, stand, and use office equipment for extended periods

    Why Join Gryphon?
    At Gryphon, every team member plays a role in delivering results for our clients and supporting one another. We believe in accountability, teamwork, and creating an environment where people can grow and succeed.

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