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Credentialing Coordinator (FT, Days - Remote)

2 days, 6 hours ago
United States
Full-time
Mid Level
Operations Specialist
Operations
Apply Now
Connections Health Solutions

Connections Health Solutions

Connections Health Solutions offers 24/7 mental health care with compassion and respect, providing crisis and emergency psychiatric care in Phoenix and Tucson, AZ. They pioneer behavioral health crisis care, emphasizing personalized treatment and cost-...

Health Care Providers & Services
201-500
Founded 2009
$58M raised
View All Jobs 3

Description

  • Manage end-to-end onboarding, credentialing, recredentialing, and payer enrollment for providers, behavioral health support staff, and facilities.
  • Maintain provider records in Medallion, including NPI, licenses, practice locations, payer information, and supporting documentation.
  • Request, track, and follow up on credentialing documents and provider profile completion.
  • Research state licensing, supervision, collaborative agreement, and scope-of-practice requirements for MDs, DOs, NPs, and PAs.
  • Complete primary source verifications and escalate adverse findings for credentialing committee review.
  • Coordinate malpractice coverage additions and maintain related documentation in credentialing systems and CAQH.
  • Manage commercial, government, Medicaid, Medicare, and telehealth enrollment processes; verify effective dates, payer IDs, and recredentialing dates.
  • Monitor provider and facility enrollment, recurring compliance requirements, license renewals, and three-year recredentialing cycles.
  • Process provider and staff terminations and notify payers in accordance with market-specific requirements.
  • Partner with HR, Talent Acquisition, medical and operational leaders; prepare credentialing reports, participate in committee meetings, and maintain workflows and SOPs.

Requirements

  • High school diploma or equivalent.
  • 2 years of experience in provider or facility credentialing, payer enrollment, or related managed care administration.
  • Knowledge of credentialing and payer-enrollment regulations, including Medicare, Medicaid, and managed care processes.
  • Ability to research and interpret state licensing board requirements for MDs, DOs, NPs, and PAs.
  • Experience using credentialing software such as Medallion or a comparable system.
  • Working knowledge of PECOS, CAQH, and state Medicaid provider portals.
  • Strong provider-facing customer service and communication skills by phone, text, and email.
  • Advanced Microsoft Office skills, particularly Excel.
  • Full vaccination or an approved exemption is required before the start date.
  • Bachelor’s degree in healthcare administration or a related field, 3+ years of behavioral health credentialing experience, CAQH/delegated credentialing familiarity, and multi-state enrollment experience are preferred.

Benefits

  • Fully remote work for candidates located in eligible listed states.
  • Comprehensive medical, dental, vision, accident, critical illness, and hospital indemnity insurance for full-time employees and families.
  • Company-paid basic life, AD&D, short-term disability, and long-term disability coverage.
  • Health Savings Account employer contribution of $1,000 to $2,000, plus healthcare and dependent-care FSAs.
  • 401(k) match after six months: 50% of deferrals up to 6% of compensation; automatic enrollment after 90 days.
  • 160 hours of annual PTO and 12 company holidays for full-time employees.
  • Company-paid parental leave for eligible employees.
  • Employee Assistance Program offering confidential emotional, work-life, financial, and legal support.

Interested in this position?

Apply directly on the company website

Apply Now

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