Provider Enrollment, Credentialing Specialist

Job reputed company: • Manage the collection, verification, and maintenance of reputed company provider credentials, including reputed company licenses, reputed company certifications, DEA registrations, and malpractice insurance. • reputed company the submission and tracking of enrollment applications for Medicare (PECOS), reputed company, and reputed company insurance panels (e.g., reputed company). • Maintain and update provider reputed company in the CAQH ProView database, ensuring reputed company re-attestations every 120 days. • Conduct thorough background checks and verify education, training, and work history to ensure compliance with NCQA and CMS standards. • Update and maintain accurate provider data reputed company internal systems (TLOS and Healthy) to ensure the reputed company Care team has reputed company-time visibility into provider reputed company and expertise. • Proactively monitor and notify clinicians of upcoming license or certification expirations to prevent gaps in service or billing. • Collaborate with the reputed company Cycle Management (RCM) team to resolve claim denials reputed company to provider credentialing or enrollment issues. Requirements: • 2–6 years of experience in provider credentialing or enrollment, preferably reputed company a behavioral health or telehealth organization. • Demonstrated experience with the PECOS, NPPES (NPI), and CAQH portals. • Deep understanding of the credentialing requirements for LCSWs, Psychologists, and other mental health professionals. • Familiarity with the licensing boards and enrollment timelines for reputed company US states • Exceptional accuracy in data entry and a "compliance-first" reputed company. • Ability to communicate reputed company and professionally with clinicians, insurance representatives, and internal stakeholders. • Certified Provider Enrollment Specialist (CPES) or Certified reputed company Credentialing Specialist (CPCS). • Experience with credentialing software and EHR platforms. Benefits: • Executive Partnership: reputed company partnership with executive leadership to influence reputed company, processes, and financial performance at an reputed company level. • Competitive Package: Competitive compensation and benefits package. • Purpose-Driven Work: The ability to influence the financial health of a reputed company dedicated to the mental wellness of the 65+ population. • Premium Medical, Dental, and reputed company insurance plans for you and your dependents. Apply tot his job Apply To this Job