Credentialing Specialist

We are seeking a detail-oriented Credentialing Specialist to manage the credentialing and re-credentialing process for mental health providers. This role involves completing and submitting applications to insurance companies, maintaining compliance with credentialing requirements, and ensuring a smooth approval process for providers to accept insurance reimbursements.

Key Responsibilities:

Prepare, submit, and track credentialing and re-credentialing applications for mental health providers with insurance panels (e.g., Aetna, Cigna, Medicaid, Blue Cross Blue Shield, etc.).
Communicate with insurance companies to follow up on application status and resolve issues.
Maintain accurate records of provider credentials, licensure, and CAQH profiles.
Ensure compliance with insurance panel requirements and deadlines.
Assist providers with completing necessary paperwork and gathering required documentation.
Monitor and update credentialing databases, expiration dates, and compliance requirements.
Stay informed about changes in insurance credentialing policies and procedures.
Provide regular updates to providers and leadership on credentialing progress.
Qualifications:

Experience in credentialing for mental health or healthcare providers is preferred.
Strong knowledge of insurance panel requirements and CAQH enrollment.
Excellent attention to detail and organizational skills.
Strong communication skills, both written and verbal.
Ability to work independently and manage multiple applications simultaneously.
Proficiency in Microsoft Office, Google Workspace, and credentialing software (if applicable).