Credentialing Specialist (Payer Enrollment)
The Judge Group, New York, NY, United States
Ready to bridge the gap between life-changing science and the patients who need it most?
Imagine taking full ownership of a laboratory’s network footprint, turning complex insurance hurdles into seamless pathways for growth. At our client’s facility, your work directly ensures that fast, accurate, and non-invasive drug testing is accessible to those who need it most.
Why Join Our Client? Our client isn't just a laboratory; they are pioneers in oral fluid drug testing dedicated to improving lives. When you join this team, you aren't just a "processor"—you are a
Revenue Architect. Impactful Work:
Your success in securing in-network contracts directly dictates the laboratory’s ability to serve patients nationwide. Vibrant Culture:
Join an intentional, high-energy environment that prizes accuracy, flexibility, and collective happiness. Professional Growth:
Operate within the
EOS (Entrepreneurial Operating System)
framework, giving you a clear seat at the table and a voice in how the business scales. Solid Rewards:
Competitive salary, comprehensive benefits (Medical/Dental/Vision/401k match), and a stable Monday–Friday, on-site schedule.
The Mission: What You’ll Accomplish As a
Credentialing Specialist , you will move beyond data entry to become a strategic liaison between the lab and the nation’s largest payers. Expand the Network:
Own the end-to-end enrollment process for commercial insurance, Medicare, and Medicaid across multiple states. Maximize Revenue:
Review payer contracts and negotiate reimbursement rates to ensure the lab is compensated fairly for its high-tech services. Build the Blueprint:
Develop and manage a centralized database to eliminate lapses and drive 100% enrollment success. Advocate & Negotiate:
Use your professional influence to navigate payer relationships and secure in-network status through persistent, high-level follow-up. Ensure Compliance:
Act as the gatekeeper for state and federal regulations, ensuring every application is audit-ready and accurate.
What You Bring We are looking for a proactive problem-solver who thrives on "getting to yes" with insurance payers. Industry Expertise:
At least 3 years of healthcare credentialing experience (Laboratory-specific or multi-state experience is a major plus). Education:
Bachelor’s degree;
CPCS certification
is highly preferred. Tech Savvy:
High proficiency in Excel and document management tools (Adobe/Foxit) to keep complex data organized. Communication Skills:
The ability to pivot from a professional negotiation with a payer to a collaborative strategy session with internal teams. The "EOS" Mindset:
A self-starter who exercises great judgment, takes initiative, and loves working toward a collective goal.
Ready to Make an Impact? If you are a detail-oriented professional who wants to be a vital participant in a growing, mission-driven business, we want to hear from you.
Apply Now to Join our Client's Team!
Imagine taking full ownership of a laboratory’s network footprint, turning complex insurance hurdles into seamless pathways for growth. At our client’s facility, your work directly ensures that fast, accurate, and non-invasive drug testing is accessible to those who need it most.
Why Join Our Client? Our client isn't just a laboratory; they are pioneers in oral fluid drug testing dedicated to improving lives. When you join this team, you aren't just a "processor"—you are a
Revenue Architect. Impactful Work:
Your success in securing in-network contracts directly dictates the laboratory’s ability to serve patients nationwide. Vibrant Culture:
Join an intentional, high-energy environment that prizes accuracy, flexibility, and collective happiness. Professional Growth:
Operate within the
EOS (Entrepreneurial Operating System)
framework, giving you a clear seat at the table and a voice in how the business scales. Solid Rewards:
Competitive salary, comprehensive benefits (Medical/Dental/Vision/401k match), and a stable Monday–Friday, on-site schedule.
The Mission: What You’ll Accomplish As a
Credentialing Specialist , you will move beyond data entry to become a strategic liaison between the lab and the nation’s largest payers. Expand the Network:
Own the end-to-end enrollment process for commercial insurance, Medicare, and Medicaid across multiple states. Maximize Revenue:
Review payer contracts and negotiate reimbursement rates to ensure the lab is compensated fairly for its high-tech services. Build the Blueprint:
Develop and manage a centralized database to eliminate lapses and drive 100% enrollment success. Advocate & Negotiate:
Use your professional influence to navigate payer relationships and secure in-network status through persistent, high-level follow-up. Ensure Compliance:
Act as the gatekeeper for state and federal regulations, ensuring every application is audit-ready and accurate.
What You Bring We are looking for a proactive problem-solver who thrives on "getting to yes" with insurance payers. Industry Expertise:
At least 3 years of healthcare credentialing experience (Laboratory-specific or multi-state experience is a major plus). Education:
Bachelor’s degree;
CPCS certification
is highly preferred. Tech Savvy:
High proficiency in Excel and document management tools (Adobe/Foxit) to keep complex data organized. Communication Skills:
The ability to pivot from a professional negotiation with a payer to a collaborative strategy session with internal teams. The "EOS" Mindset:
A self-starter who exercises great judgment, takes initiative, and loves working toward a collective goal.
Ready to Make an Impact? If you are a detail-oriented professional who wants to be a vital participant in a growing, mission-driven business, we want to hear from you.
Apply Now to Join our Client's Team!