Full-Time

Certified Provider Credentialing Specialist

Confirmed live in the last 24 hours

Circle Medical

Circle Medical

201-500 employees

Telehealth services for virtual medical consultations

Consumer Software
Healthcare

Compensation Overview

$64.5k - $65.7kAnnually

Senior

Union City, NJ, USA

Hybrid position; requires in-office presence.

Category
Risk & Compliance
Legal & Compliance
Requirements
  • 5+ years of credentialing experience with medical staff
  • CPCS or CPMSM certification
  • Proficiency in using credentialing software and databases.
  • The ability to think logically and analytically to problem-solve on a daily basis.
  • Have emotional intelligence and the ability to possess self-awareness and base decisions on your analysis of facts.
  • Strong time management and prioritization skills to make sound business decisions.
  • In-depth knowledge of the clinical, healthcare, and telemedicine standards, regulations, and medical credentialing and privileging procedures and standards.
  • Excellent communication skills; written, verbal, as well as auditory
  • Familiarity with healthcare, telehealth, and regulatory terminology.
  • Professional integrity to adhere to professional confidentiality standards in accordance with HIPAA, legal, ethical, and company policies
  • Critical thinking skills to exercise sound independent judgment and discretion in applying departmental policies and procedures while handling confidential medical staff, risk management, and peer review information.
Responsibilities
  • Track credentialing and licensing status for our providers
  • Implement and manage an effective credentialing and licensure program
  • Lead and monitor all credentialing, re-credentialing, and provider enrollment processes
  • Maintain a database of provider certifications and renewal dates
  • Confirm that provider credentials match the requirements of their job
  • Help full-time providers apply for or renew credentials which may include finding test dates and locations, identifying CME requirements, or submitting applications and payments on their behalf
  • Ensure staff coordination and administration of the credentialing and licensing process for certified staff and providers
  • Assist with cross-state licensure process
  • Review, analyze and create practitioner credentialing applications, privileging forms, and standardized communications in an effort to improve communication and compliance
  • Identify and communicate all concerns regarding practitioner credentialing and enrollment to appropriate parties; follow up when necessary to ensure affected parties and departments are notified of concerns in an appropriate time frame
  • Monitor for provider sanctions and collaborate with appropriate teams to action accordingly
  • Develop and review company policies
  • Communicate with government agencies
  • Other duties as assigned by management

Circle Medical provides telehealth services that allow individuals to access healthcare without visiting a physical clinic. The company connects patients with licensed healthcare providers through secure video chat, enabling virtual consultations for general medical issues, annual wellness exams, well-woman exams, and COVID-19 testing assessments. This approach enhances accessibility and reduces the need for in-person visits, which is especially useful during public health crises. Circle Medical generates revenue through insurance reimbursements and out-of-pocket payments, accepting all major insurance plans and offering a transparent billing process. The company targets tech-savvy individuals who value convenience and efficiency in their healthcare experience.

Company Stage

Acquired

Total Funding

$12.2M

Headquarters

San Francisco, California

Founded

2015

Growth & Insights
Headcount

6 month growth

7%

1 year growth

2%

2 year growth

7%
Simplify Jobs

Simplify's Take

What believers are saying

  • Growing demand for telehealth post-COVID-19 boosts Circle Medical's market potential.
  • AI integration with HEALWELL enhances operational efficiency and patient outcomes.
  • Hybrid healthcare models offer flexibility, aligning with Circle Medical's service offerings.

What critics are saying

  • Integration challenges with HEALWELL's AI could disrupt operations if not managed well.
  • Strategic shifts from new AI leadership may impact current service delivery.
  • WELL Health's investment might lead to governance changes, causing internal disruptions.

What makes Circle Medical unique

  • Circle Medical offers both in-person and virtual healthcare services.
  • The company integrates AI to enhance electronic medical records and patient care.
  • Circle Medical accepts major insurance plans, ensuring broad patient accessibility.

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