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Credentialing Coordinator

6 hours, 34 minutes ago
United States
Full-time
Junior
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
51-250
Founded 2009
$58M raised
View All Jobs 2

Description

  • Manage provider onboarding from HR notification through completion of Medallion profiles.
  • Request, track, verify, and maintain provider credentials, including licenses, NPIs, DEA registrations, certifications, CAQH, and PECOS records.
  • Research state licensing, supervision, collaborative agreement, and scope-of-practice requirements across MD, DO, NP, and PA provider types.
  • Complete primary source verifications, including NPI, NPDB, OIG, SAM, DEA, state licensure, and Medicare/Medicaid checks.
  • Manage commercial and government payer enrollment, recredentialing, effective dates, payer IDs, and enrollment records.
  • Maintain CAQH profiles and attestations, malpractice insurance documentation, and related credentialing platform records.
  • Support multi-state and telehealth licensing, state Medicaid registration, Medicare enrollment, and facility enrollment processes.
  • Manage credentialing and enrollment for behavioral health support staff, including NPI and Medicaid enrollment tracking.
  • Process provider and staff offboarding and notify applicable payers of departures.
  • Collaborate with HR, Talent Acquisition, Medical Leadership, and operations; prepare reports, participate in quarterly credentialing committees, and maintain SOPs.

Requirements

  • High school diploma or equivalent required.
  • At least 2 years of experience in provider or facility credentialing, payer enrollment, or related managed care administration.
  • General knowledge of credentialing, Medicare, Medicaid, managed care, and payer enrollment requirements.
  • Ability to research and interpret licensing requirements for MD, DO, NP, and PA providers.
  • Experience using Medallion or a comparable credentialing management platform.
  • Working knowledge of PECOS, CAQH, and state Medicaid provider portals.
  • Strong customer service and communication skills, including phone, text, and email communication with providers.
  • Advanced proficiency with Microsoft Office, particularly Excel.
  • Bachelor’s degree in healthcare administration or a related field preferred.
  • Three or more years of behavioral health credentialing experience, CAQH attestation and delegated credentialing knowledge, or multi-state enrollment experience preferred.
  • Must meet the company’s mandatory vaccination policy or qualify for an approved exemption before starting.

Benefits

  • Fully remote position available in specified U.S. states.
  • Comprehensive medical, dental, vision, accident, critical illness, and hospital indemnity insurance for employees and families.
  • Company-paid basic life, AD&D, short-term disability, and long-term disability coverage.
  • Health Savings Accounts with a $1,000–$2,000 employer contribution, plus healthcare and dependent-care FSAs.
  • 401(k) plan with company matching after six months; automatic enrollment after 90 days.
  • PTO starting at 160 accrued hours annually and 12 company holidays.
  • Company-paid parental leave for eligible employees.
  • Employee Assistance Program with emotional, financial, legal, and work-life support.

Interested in this position?

Apply directly on the company website

Apply Now

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