Licensing and Credentialing Specialist

Summary

Join us in helping individuals with OUD improve their health and quality of life by ensuring our clinicians are properly credentialed, licensed, and enrolled in payor networks to care for our patients.

Requirements

• Associates degree or equivalent combination of education and/or experience
• 3-5 years of working experience in a credentialing and enrollment setting required
• Knowledge of multi-state/national provider credentialing and/or enrollment required
• Experience with PECOS/Medicare and/or state Medicaid enrollment platforms
• Knowledge of Google Workplace/Microsoft office or other task management suites

Responsibilities

• Review provider initial and reappointment credentialing applications, ensuring compliance with industry standards
• Conduct primary source verification and coordinate the credentialing committee review process
• Ensure new and renewed license, DEA, and CSR requests are submitted promptly
• Follow up directly with providers to gather missing or incomplete information for enrollment submissions
• Submit enrollment packets to payers (MCOs, Medicare, Medicaid) in an accurate and timely manner
• Monitor enrollment status and address any delays by following up with payers to expedite credentialing approvals
• Enter and maintain accurate provider enrollment data in internal and external databases, including CAQH and payer portals, by updating demographic information, practice locations, termination of providers, and other maintenance forms as required
• Act as a point of contact between providers, payors, and internal teams to resolve issues related to credentialing, enrollment, and reimbursement

Benefits

• Generous health care coverage (Blue plans + Kaiser in California) - many plans are fully covered for the employee!
• Up to 4 weeks of PTO annually (no waiting period) and 10 company holidays
• 401k contribution platform
• Remote-first work environment
• $1,000 work-from-home stipend
• Life insurance, short and long term disability