Provider Credentialer (Work-from-Home)

We are seeking a detail-oriented Provider Credentialer to support our mental health group practice. This role ensures our therapists, counselors, and mental health professionals are properly credentialed with insurance companies and regulatory agencies.

Key Responsibilities:
Manage the full credentialing lifecycle, including initial credentialing, re-credentialing, and privileging.
Verify and maintain provider qualifications, licenses, malpractice insurance, and continuing education records.
Coordinate with providers to collect and submit necessary documentation to insurance companies and credentialing organizations.
Work with insurance companies and CAQH to ensure provider enrollment and network participation.
Ensure compliance with HIPAA, Medicare, NCQA, URAC, and Florida mental health regulations.
Track expiration dates for licenses and initiate re-credentialing.
Resolve credentialing issues to prevent billing disruptions.
Qualifications:
HIPAA Certified with 2-5 years of mental health provider credentialing experience.
Strong knowledge of payer-specific requirements and mental health credentials (LCSW, LPC, LMFT, PhD/PsyD, etc.).
Familiarity with insurance panels (Aetna, BCBS, Cigna, Humana, Tricare, UnitedHealthcare).
Proficiency in credentialing software, Microsoft Office, and provider databases.
Excellent organizational and communication skills.
Must have a work-from-home setup.

Preferred:
Certified Provider Credentialing Specialist (CPCS) or similar certification.
Experience in a mental health group practice.
We’re looking for a proactive, detail-oriented professional who can work with minimal supervision. If you're passionate about ensuring seamless provider credentialing, apply today!

Starting pay is $3.5/hr