Healthcare Licensing and Credentialing
1 week ago
Summary:
Responsible for verifying provider licensing and credentials, managing payer enrollment, and ensuring compliance with healthcare standards. Supports timely credentialing and re-credentialing for providers.
Responsibilities:
- Collect and verify provider documents (licenses, education, certifications, malpractice, etc.).
- Process credentialing and re-credentialing applications with payers (Medicare, Medicaid, commercial plans).
- Maintain provider files, databases, and systems (e.g., CAQH, NPPES, PECOS).
- Track expirations and ensure timely renewals.
- Communicate application status and requirements to providers and internal teams.
- Ensure compliance with HIPAA, NCQA, Joint Commission, and other regulations.
Qualifications:
- Experience in healthcare credentialing or provider enrollment preferred.
- 2+ years in Behavioral Health credentialing
- Experience working in Modio credentialing database
- Knowledge of CAQH, PECOS, and payer requirements is an advantage.
- Strong attention to detail, organization, and communication skills.
- Proficient with Microsoft Office and credentialing systems.
- Willing to work US hours from Monday to Friday
Why join us as?
You'll see dozens of marketing analysis set-ups, you'll learn how marketing strategies are built, what matters, and why. You'll have the opportunity of solving real customer problems on an everyday basis.
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