Payer Credentialing Specialist

 Posted an hour ago
     
 $55000 - $70000 per year
  
0-2 years experience
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AI Summary

Manage end-to-end credentialing and recredentialing processes for providers while coordinating payer enrollment applications. Ensure compliance with regulatory standards and collaborate with internal teams to resolve credentialing-related issues.

👋 Meet knownwell, weight-inclusive healthcare for all. Join a dynamic company that is changing the way obesity care is delivered. We offer weight management, primary care, nutrition counseling, and health coaching. Our care model combines in-clinic and virtual care to bring support to patients where and when they need it.

 

Backed by $50M in funding—including a $25M round led by CVS Health Ventures with support from a16z Bio + Health, Flare Capital, MassMutual, and Intermountain Ventures—we’re scaling fast and expanding access to evidence-based obesity care nationwide.

 

To achieve our ambitious goals, we're looking for a Payor Credentialing Specialist to join our Operations team. This role will support all things credentialing at knownwell, and play a critical role in building, shaping, and scaling our network so that all Americans have access to our services.

This is a behind-the-scenes role that keeps our entire provider network running — you won't be patient-facing, but the accuracy and pace of your work will directly determine how quickly we can bring clinicians online and keep them compliant. The ideal candidate takes ownership, works independently, and knows how to flag urgency when something needs to move fast. You're methodical by nature, catch the details others miss, and are comfortable juggling multiple priorities without losing accuracy along the way.

Responsibilities

  • Manage end-to-end credentialing and recredentialing processes for new and existing providers, including verification of education, training, board certifications, and work history.

  • Coordinate payer enrollment applications and updates to ensure timely processing and provider participation across commercial and government payers.

  • Maintain accurate and up-to-date credentialing files and records in compliance with internal standards and regulatory requirements.

  • Collaborate with providers, health plans, and internal departments to resolve any credentialing-related issues or delays.

  • Track credentialing timelines and proactively follow up on outstanding applications or documentation.

  • Ensure compliance with NCQA, CMS, state, and payer-specific regulations and standards.

  • Participate in audits, surveys, and reporting related to provider credentialing and enrollment.

  • Support cross-functional teams including clinical operations, revenue cycle, and human resources with credentialing-related information and processes.

Qualifications

  • Minimum of 1 year of experience in provider credentialing and payer enrollment, preferably in a multi-state medical group or healthcare organization. If you don’t have a full year of experience but think you'd be a great fit, we still want to hear from you — please apply.

  • Strong ownership mindset — you take responsibility for your work from start to finish. This is a remote role, so we need someone who is self-directed by default.

  • High level of accuracy and attention to detail, with a methodical approach to tracking applications, deadlines, and documentation. Your progress is easy to verify at any point along the way.

  • Reliable follow-through — when you commit to a timeline, you hit it. You spot potential delays early and speak up right away to help get things back on track.

  • Direct and transparent communicator — providers, health plans, and internal teams always get the real status, good news or not.

  • Excellent time management and the ability to juggle multiple credentialing tasks and deadlines simultaneously without letting anyone slip through the cracks.

Nice to have

  • Familiarity with CAQH, NPPES, and PECOS.

Pay & Perks:

💻 Fully remote opportunity

🩺 Medical, dental, and vision insurance

📈 401K retirement plan with company match

🏝️ Up to 20 days of PTO per year + company holidays

👶 Up to 14 weeks of parental leave (12 for non-birthing parents) 

🏡 Annual work from home stipend for remote employees

 

knownwell, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 

 

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.  Based on current size of the clinic and HIPAA regulation, providers cannot receive care in clinic and provider’s household members cannot receive primary care in the clinic. 

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