Contract and Credentialing Specialist - Healthcare (remote)

ABOUT PRECISION DIAGNOSTICS:

Precision Diagnostics, based in San Diego, California is a fast-growing clinical laboratory that specializes in providing drug testing, primarily for the purpose of helping physicians monitor their patients undergoing treatment for pain or substance abuse. Precision’s objective is to improve patient adherence/compliance with their prescription regimen and protect medical practices from liability.  

THE ROLE:

We are looking for a Contract & Credentialing Specialist (Healthcare - Prefer Hybrid Schedule; San Diego, CA but open to fully REMOTE) for our Payor Credentialing Department. This role ensures facilities have accurate credentials. Responsibilities include completing initial credentialing, revalidation/recredentialing, and contracting applications at regional and national levels. Key tasks involve primary source verification, monitoring license updates, and ensuring compliance with state and federal requirements.

The Specialist reports to the VP of Credentialing and Contracting and must know regulations, standards, and practices to maintain licensure, credentials, and managed care contracts. This position requires attention to detail, tracking multiple timelines, and interacting effectively with medical professionals, office staff, and stakeholders.

OUTCOMES:

• Exceptional quality in completion standards of all credentialing and contracting applications.
• Prioritize and monitor existing contract and credential status.
• Maintain the Company’s Contract & Credentialing database to ensure that current and accurate information, including payer contracts, state credentials, fee schedules, expiration dates and application statuses, is available to all stakeholders.
• Perform other credentialing and contracting duties as requested.

WHAT YOU BRING TO THE TABLE:

• 3 - 5 years of experience with U.S. healthcare contracting and or credentialing.
• Competency in EDI/ERA/EFT.
• Must be able to successfully maintain multiple projects simultaneously, manage and meet multiple deadlines, be detail-oriented, and possess strong organizational skills.
• Excellent verbal and written communication skills as well as listening skills and reading and writing comprehension to technical and non-technical audiences of various levels within the organization (e.g., executive, management, individual contributors).
• Clerical office, data entry, e-filing, and customer interfacing/communication experience required (preferably in a healthcare setting).
• Ethical conduct and the ability to respect and preserve confidential information entrusted in the course of professional duties is necessary. Reveals confidential information only to appropriate parties and in accordance with any applicable law. Maintains confidentiality regarding legal matters, privacy issues, information technology, and data integrity.
• Excellent problem solving, time management, and work prioritization skills.
• Ability to establish and maintain positive relationships with internal and external customers and be a team player.
• Performs other related duties as assigned.
• To be successful, you agree that technology is a key part of every business process, and you will make new technology adoption part of your routine.
• Become fluent in Microsoft 365 (formerly Office635) applications assigned to your role. Common applications include Teams, Word, Excel, Tasks and Planner.
• Complete training in a timely manner that is assigned to you.  Training is primarily conducted via Microsoft Learn modules and is assigned based on:
• Position/Job Role - Most positions require a core set of Microsoft 365 working knowledge.
• Project Role - As member of a project team, you may be required to complete training before you can engage with the project team or commence project work.
• Ad-Hoc - Based on review of your performance via support requests, training modules will be assigned to increase skills.

WHAT WE BRING TO THE TABLE:

• Comprehensive benefits package: Medical, Dental, Vision, and additional optional coverages.
• 401K with company match.
• Paid time off and paid Holidays.
• Precision is dedicated to giving back to our communities through various platforms such as:
  • Sponsoring high school students with limited economic means.
  • Annual company food drive with Precision matching each employee donation.
  • Precision Cares program, partnering with local communities each year to give back.
• Frequent company events to keep our employees connected such as:
  • Lab Week: To celebrate and recognize the value our Lab Team members contribute.
  • Compliance Week: To shine a light on the importance of compliance & ethics.
  • National Sales Meeting in San Diego for all Sales team members to connect and learn.

ADDITIONAL JOB CONSIDERATIONS:

• For roles located in office or home setting; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear.
• The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height).
• Specific vision abilities required by this job include the ability to see things from a close distance and the ability to adjust focus.
• Role must be available to attend video / audio team calls daily.
• Please be advised this job description is subject to change at any time.
• Full time.
• 8 hour shift, M-F 8am PST to 4pm PST.
• The hourly range for this role is $32.70 - $33.65.
• Hybrid preferred position - Remote 3 days per week and onsite 2 days per week at our San Diego, CA office. Open to fully remote if needed.
• Must be able to sit at a desk for prolonged periods and work on a computer. 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.  

Precision is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on 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 employment practices within our organization, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Precision Diagnostics makes hiring decisions based solely on qualifications, merit, and business needs at the time.