Credentialing Specialist - Medical Billing

Position: Credentialing Specialist - Medical Billing

Location: Houston, TX

Remote Status: Remote

Job :149-CD

# of Openings:1

Job Title:

Credentialing Specialist

Location:

Remote

Schedule:

Full-Time

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.

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.

• 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 Credential Stream 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
• Working knowledge of EFT/ERA enrollment for all payers

College degree preferred. High School graduate or equivalent required.

2 years of experience in credentialing preferred. Experience with Credential Stream preferred.

• 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

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.

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.