Remote Contracting and Credentialing Specialist

FORTA’S MISSION:

Forta is clearing the path to quality healthcare by delivering the best possible outcomes with the utmost convenience. 1 in 36 children [CDC, 2023] is diagnosed to be on the autism spectrum.  Currently, autism support via Applied Behavior Analysis (ABA) is difficult to access and the delivery model must be expanded to provide earlier access to families.  

Forta is not only providing ABA services to our clients, but we’re also improving the future of the ABA experience for families by creating software and predictive algorithms that elevate clinicians to work smarter by surfacing the latest and most relevant case data.  We are working diligently to continuously improve the patient journey and deliver personalized care by applying smart technology and investing in the growth of our world-class team.  

We are looking for a skilled Contracting and Credentialing Specialist to join Forta's dynamic team. In this role, you will handle contracting and credentialing needs for our US-based health care providers, diagnostic laboratories, and medical facilities as preferred providers in health care networks. This role is entirely Remote, and candidates must be comfortable working from 6 PM to 3 AM IST to align with U.S. business hours.

What you will do:

• Prepare, submit, and manage contracting and credentialing applications to insurance payors across multiple U.S. states
• Communicate with payors, clinicians, and verification bodies, track application progress, and ensure timely follow-ups and completion; this includes proactive payor contact to ensure applications are filled out correctly
• Assist with hiring and onboarding clinicians and act as the primary point of contact for all affiliated clinicians
• Maintain accurate records and update dashboards, tracking tools, and other documents as required
• Alert providers of new regulations, expiring certificates, reapplications, and deficiencies in credentialing requirements.
• Work with internal teams to correct and/or amend rejected contracting applications; update internal workflows to reflect current best practices based on up-to-date payor and industry requirements as well as advise on potential concerns or improvements.
• Train team members with varying levels of experience and seniority in contracting and credentialing processes.

What you bring:

• At least 2 years experience in the US-based contracting and credentialing process for providers.
• Deeply familiar with the US medical insurance industry and have worked with multiple insurance providers through the credentialing process. Medicaid and Medicare experience is a plus.
• Excellent English speaking, listening, and written communication skills and dependably high levels of responsiveness. 
• Able to work autonomously with minimal supervision, report regularly, and execute work plans thoroughly. 
• Highly organized and detail-oriented with strong follow-up skills.
• Comfortable using Google Workspace, tracking tools, and internal platforms.
• BYOD - must have a secure device compatible with required software/applications (e.g. VPN, Google workspace) and be willing to adhere to company security practices.

Forta

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Forta is a Drug-Free Workplace/ EO employer – M/F/Veteran/Disability.