Regulatory Compliance Specialist
2 weeks ago
We are seeking a Regulatory Compliance Specialist to join our team. As a key member of our team, you will be responsible for staying up-to-date on industry standards and payer policies to ensure timely and compliant credentialing.
The ideal candidate will have 2-5 years of experience in provider credentialing, preferably with mental health providers. They will be familiar with major insurance providers and HIPAA regulations.
Key Responsibilities:
- End-to-End Credentialing & Re-Credentialing – Oversee the entire credentialing process for healthcare providers.
- Insurance Panel Enrollment – Ensure timely enrollment with major insurance payers while maintaining compliance.
- Regulatory Compliance – Stay updated on industry standards (NCQA, URAC, AHCA) and payer policies.
- Liaison & Coordination – Collaborate with providers, insurers, and internal teams to ensure smooth approvals.
What We're Looking For:
- Experience – 2-5 years of experience in provider credentialing (Mental Health provider credentialing preferred).
- Industry Knowledge – Familiarity with major insurance providers (Aetna, BCBS, Cigna, etc.) and HIPAA regulations.
- Detail-Oriented & Proactive – Strong analytical skills and the ability to multitask in a fast-paced environment.
- Tech-Savvy – Comfortable using credentialing software and databases.
- Strong Communication Skills – Ability to effectively coordinate with stakeholders and ensure compliance.
- Work-from-Home Ready – Dual monitor setup, extra laptop or backup device, primary ISP with a backup connection, and an emergency power source.
Location: Open to candidates based in the Philippines.
How to Apply: Please complete the following steps: Take the Strengths Test: https://high5test.com/, Take the Personality Test: https://www.16personalities.com/ Once you have completed the tests, submit your application by emailing your test results along with your resume to cservice@coolblueva.com with the subject: PERSONALITY AND STRENGTH TEST RESULT – [Your Full Name]
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