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Licensing & Credentialing Specialist (Remote, W2)

2 weeks ago
United States
Full-time
Junior
Human Resources
Operations
HIPAA
Apply Now
CareTalkHealth

CareTalkHealth

CareTalk Health is a company that empowers businesses to enhance customer engagement and loyalty through effective Monetization Strategies. They offer services such as Doctors Visits, Annual Wellness Visits, CCM, RPM, and RTM, focusing on improving the...

Health Care Providers & Services
1-10
Founded 2018
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Description

  • Manage full-cycle provider credentialing and recredentialing in compliance with CMS, NCQA, and state regulations.
  • Oversee medical payer enrollment submissions for commercial payers and government entities, including Medicare.
  • Complete and manage PECOS and CMS 855i enrollments and related updates.
  • Maintain and update CAQH profiles to ensure accuracy and attestation compliance.
  • Track active licenses and expiration dates for providers and nursing staff in Modio and coordinate renewals.
  • Research and interpret 50-state licensure, scope of practice, and NP collaborative agreement requirements.
  • Coordinate collaborative agreements in accordance with state-specific requirements.
  • Monitor credentialing status and resolve issues or delays with payers and regulatory agencies.
  • Review credentialing applications against NCQA and accreditation standards.
  • Maintain accurate, confidential provider data across credentialing databases, CAQH, NPPES, PECOS, and payer portals.
  • Collaborate with recruiting, operations, and compliance teams to support timely onboarding.

Requirements

  • 3+ years of experience in healthcare credentialing, licensing, and payer enrollment.
  • Strong knowledge of CMS regulations, Medicare enrollment processes, and multi-state licensing requirements.
  • Hands-on experience with CAQH, PECOS, NPPES, and payer portals.
  • Experience managing 855i applications and Medicare provider enrollment workflows.
  • Experience tracking multi-state licensure and expirations for providers and nursing staff, including RNs, LVNs, and LPNs.
  • Experience researching and applying state-specific regulatory requirements, including NP collaborative agreements.
  • Knowledge of credentialing standards including NCQA.
  • Strong database management experience within credentialing systems.
  • Exceptional organizational skills with strong attention to detail.
  • NAMSS certification preferred, including CPCS or CPMSM.
  • Ability to operate independently in a remote environment.
  • Strong communication, analytical, and cross-functional collaboration skills.
  • Windows or Apple (macOS) computer only; no Chromebooks, Linux machines, or smartphones.
  • Must have Windows 10 or macOS 14 Sonoma or later.
  • Processor: Intel Core i5 or AMD equivalent for Windows; Apple Silicon for Macs.
  • 16 GB RAM required.
  • Wired headphones required; no built-in mics.
  • Minimum internet speed of 100 Mbps download and 50 Mbps upload, with ethernet connection to router.
  • Must use Google Chrome with Amazon Workspaces.
  • Webcam required for video calls.
  • Second monitor recommended for laptop users; dual monitors recommended for PC users.

Benefits

  • 100% remote work.
  • Full-time W2 hourly employment.
  • $30 per hour compensation.
  • Opportunity to support a nationwide telehealth clinical workforce.
  • Equal opportunity employer environment.

Interested in this position?

Apply directly on the company website

Apply Now

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