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Full-time
associate degree, bachelor degree
Posted 18d ago
~40 hrs/week
Responsibilities
The specialist manages healthcare provider credentialing, including verification of licenses and certifications and enrollment with insurance payers. They also support patient account activities and coordinate with billing teams to ensure seamless revenue cycle operations and regulatory compliance.
Requirements
Candidates should ideally hold an Associate's or Bachelor's degree in Healthcare Administration or Business with 2-3 years of experience in credentialing or provider enrollment. Proficiency in credentialing software and certifications like CPCS or CPMSM are preferred.
Full job description
Company Description
La Rabida Children’s Hospital provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay.
Our not-for-profit hospital, licensed for 49 beds, helps transition children from neonatal or pediatric intensive care to home, by providing medical, rehabilitative and developmental care, and by training families to continue treatments and manage the necessary equipment in the home. La Rabida also provides extensive rehabilitation for those recovering from wounds or burns and treatment for exacerbations of chronic conditions.
The hospital’s enhanced pediatric patient-centered medical home provides primary care to children with complex medical conditions and their siblings. Children with medical homes elsewhere come to La Rabida for specialty services. La Rabida offers a wide range of specialty services provided to children with sickle cell disease, diabetes, and many others. Children are supported in their emotional and developmental growth, particularly in cases where such growth has been interrupted by accident or disease.
Finally, La Rabida provides forensic and treatment services for children exposed to abuse and neglect, comprehensive assessments for youth in care, early intervention for children between 0 and 3 years of age. Care coordination services for medically complex children are also provided for those who are covered by a health plan and receive care from providers in Cook County
Job Description
SUMMARY: A Credentialing and Patient Accounts Specialist verifies healthcare provider credentials, manages enrollment with payers, tracks license and certification expirations, and supports patient account activities to ensure compliance and smooth billing operations. The Credentialing and Patient Accounts Specialist is responsible for managing the credentialing of healthcare providers, ensuring all necessary licenses, certifications, and qualifications are valid and up to date. Additionally, this role oversees patient account processes related to provider enrollment, insurance verification, and coordination with billing teams to prevent claim delays. This position is crucial for maintaining regulatory compliance, accurate provider records, and seamless revenue cycle operations.
ESSENTIAL FUNCTIONS
Provider Credentialing & Verification
o Collect, verify, and maintain provider credentials, licenses, certifications, and other required documentation
o Perform primary source verification for education, medical training, licensure, DEA registrations, and malpractice coverage
o Submit initial and Recredentialing applications to insurance payers including Medicare, Medicaid, and commercial plans
o Monitor expiration dates for licenses, certifications, and insurance, initiating renewals as needed
o Maintain organized, audit-ready credentialing files and prepare reports for committees or leadership
Patient Accounts Support
o Communicate provider enrollment status with revenue cycle management (RCM), billing teams, and leadership to avoid claim delays
o Troubleshoot enrollment rejections, data mismatches, or payer requests to ensure timely processing
o Maintain accurate records of provider participation and insurance plan affiliations in credentialing databases.
Compliance & Regulatory Duties
o Ensure all credentialing and patient account processes comply with NCQA, The Joint Commission, CMS, and state regulatory standards
o Stay current with federal and state regulations related to provider credentials and insurance.
o Participate in audits and provide data or documentation as required.
o Develop and enhance internal credentialing and patient account processes
Communication & Coordination
o Coordinate between internal departments, providers, and external agencies to collect necessary information and resolve issues
o Respond to inquiries from providers or payers regarding credentialing and enrollment processes.
o Provide guidance or training to other staff on credentialing workflows, software use, and documentation standards.
Qualifications
Education:
Associate’s or Bachelor’s degree in Healthcare Administration, Business, or a related field preferred; comparable experience may be considered.
Related Work Experience:
2-3 years in credentialing, provider enrollment, or healthcare administrative support; experience with patient accounts or billing is a plus
Proficiency with credentialing software and databases (e.g., CAQH, PECOS, NPPES, VerityStream, Cactus, IntelliSoft)
Familiarity with Microsoft Office, particularly Excel and Word
Exceptional attention to detail and accuracy
Strong organizational and time-management abilities
Effective communication skills to liaise with providers, payers, and internal Teams. Ability to manage confidential information and multi-task under pressure
Additional Information
All your information will be kept confidential according to EEO guidelines.
La Rabida is a place unlike any other. We understand the needs of families with children dealing with the most serious or complicated of conditions. With teams of the best healthcare providers in Chicago, we give continuous, comprehensive care, education, and support, helping families face their unique obstacles head-on.
La Rabida Children’s Hospital is very proud to be an Equal Employment Opportunity Employer.
We offer gold-standard care to every child with complex medical needs, regardless of a family’s financial circumstance.
Industry
Hospitals and Health Care
Company size
201-500 employees
Founded
1893
Headquarters
Chicago, Illinois
LinkedIn followers
7,401
Total funding
$600K
La Rabida Children’s Hospital is a pediatric acute care hospital, specializing in the treatment of chronic illnesses and developmental disabilities. La Rabida provides family-centered interdisciplinary care to 7,500 children with special healthcare needs each year at its lakeside location in Chicago. See our open jobs at https://larabidajobs.com/#job-feed
Offices: 6501 S Promontory Dr, Chicago, Illinois 60649, US · 200 Lakewood Blvd., Park Forest, Illinois 60466, US · 1525 E 55th St, Ste 203, Chicago, Illinois 60615, US · 12701 W 143rd St, Ste 280, Homer Glen, Illinois 60491, US · 9660 Wicker Ave, St John, Indiana 46373, US
DiabetesAsthmaSickle Cell DiseaseDevelopmental RehabilitationBrain InjuryBronchopulmonary DysplasiaChild Trauma and AbusePrimary Care for Children with Healthcare NeedsTechnology Dependencyand Burn Rehabilitation
How many Administrative jobs are open in Chicago, IL right now?
There are currently 3,301 open administrative positions in Chicago, IL listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Administrative roles in Chicago, IL?
Companies currently hiring include Chicago Public Schools, Northwestern Medicine, Becker Friedman Institute for Economics, Ann & Robert H. Lurie Children's Hospital of Chicago, UChicago Medicine Ingalls Memorial, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Administrative jobs in Chicago, IL?
Yes — 830 of the 3301 open administrative positions offer remote or hybrid work (140 remote, 690 hybrid).
How do I apply for Administrative jobs in Chicago, IL?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.