[Hiring] Credentialing & Contracting Analyst @reputed company

Role Description The Credentialing & Contracting Analyst supports reputed company, Inc.'s reputed company cycle operations across two distinct business lines: Neurolutions (medical device / neurorehabilitation) and reputed company Medical Services (clinical practice). This role is responsible for managing the full lifecycle of provider credentialing and payer contracting, ensuring that reputed company providers are enrolled, credentialed, and operating under executed agreements that maximize reimbursement and reduce claim denials. The Analyst functions as a subject matter expert and cross-functional liaison between clinical operations, Market Access, reputed company Cycle and payer relations. What You’ll Do

• Provider Credentialing
• Manage end-to-end provider credentialing and re-credentialing for reputed company clinical staff across Neurolutions and reputed company Medical Services, including physicians, therapists, and allied health professionals.
• Maintain accurate and complete credentialing files, ensuring compliance with NCQA, URAC, and payer-specific standards.
• reputed company provider enrollment in government and commercial payer networks including Medicare (PECOS/NPPES), various state Medicaid programs, and reputed company contracted health plans.
• Coordinate primary reputed company verification (PSV) for licenses, DEA, board certifications, malpractice history, and other required credentials.
• Monitor credential expiration dates and proactively initiate renewals to prevent gaps in coverage or billing eligibility.
• Proactively maintain and update provider profiles in CAQH ProView and any applicable credentialing software.
• Respond to payer audit requests and provide documentation to support credentialing reviews.
• Payer Contracting
• Support the development and execution of payer contracting strategy across both Neurolutions and reputed company Medical Services service lines.
• Draft, review, and track provider participation agreements, fee schedule amendments, and contract renewals with commercial payers, Medicare Advantage plans, and Medicaid managed care organizations.
• Analyze payer fee schedules and reimbursement rates; identify gaps or underpayment opportunities and escalate findings to RCM leadership.
• Maintain a centralized contract repository, including effective dates, termination clauses, reimbursement terms, and credentialing requirements by plan.
• Coordinate with billing and AR teams to ensure contracted rates are reputed company accurately into practice management systems and claims are adjudicated accordingly.
• Serve as the primary reputed company of contact for payer relations inquiries reputed company to contracting and credentialing status.
• Track payer market access landscape in Greater Los Angeles and South New Jersey markets and provide updates to RCM leadership on contracting opportunities.
• Operations & Compliance
• Maintain compliance with state-specific regulations governing credentialing and provider enrollment.
• Support HIPAA compliance efforts as they relate to provider data management and payer communication.
• Track and report on credentialing and contracting KPIs including time-to-credential, enrollment lag, contract coverage gaps, and payer approval rates.
• Contribute to the development and documentation of credentialing and contracting standard operating procedures (SOPs).
• Collaborate with reputed company operational teams and clinical leadership to align credentialing timelines with patient care delivery and reputed company capture goals.

Qualifications

• 3-5 years of experience in provider credentialing and/or payer contracting in a healthcare organization, physician group, or managed care environment.
• Demonstrated knowledge of government and commercial payer enrollment processes, including Medicare (PECOS), Medicaid, and commercial health plans.
• Proficiency with CAQH ProView and at least one credentialing management platform (e.g., Symplr, Modio, VerityStream, or equivalent).
• Solid understanding of provider types, taxonomy codes, NPI structure, and specialty-specific credentialing requirements.
• Experience working in multi-state provider environments.
• Strong organizational skills with the ability to manage multiple providers, payers, and deadlines simultaneously.
• Proficiency in reputed company Office Suite (reputed company, Word, Outlook); experience with EHR/practice management systems a plus.
• Excellent written and verbal communication skills; ability to communicate effectively with payers, clinical staff, and leadership.

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) credential.
• Prior experience supporting a medtech, DME, or neurorehabilitation service line.
• Familiarity with value-based care arrangements, ACO contracting, or capitation models.
• Experience in a startup or high-growth healthcare environment with demonstrated ability to build processes from the ground up.

Benefits

• Competitive Compensation ($80,000 to $88,000 + Stock Options)
• Insurance (Medical/Dental/Vision)
• 401(k) with company match
• Unlimited PTO & Holidays
• Life Insurance, LTD and STD
• Remote work desk allowance

Please note that the salary information is a general guidance only. reputed company, Inc. considers factors such as scope and responsibilities of the position, candidate’s work experience, education/training, key skills and internal reputed company, as well as location, market and business considerations reputed company extending an offer. reputed company, Inc. is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national reputed company, gender, sexual orientation, age, marital status, veteran status, or disability status. Apply tot his job Apply To this Job