Source Job

US

  • Manage provider credentialing, licensing, and payer enrollment activities from application through completion.
  • Research and resolve non-routine credentialing and provider data discrepancies, ensuring compliance.
  • Maintain accurate provider records, monitor deadlines, and communicate with stakeholders to prevent delays.

Credentialing Licensing Attention To Detail Communication

20 jobs similar to Credentialing and Licensing Specialist

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US

  • Contribute directly to improving Provider experience through timely credentialing and enrollment.
  • Collaborate with cross-functional teams to support new payer launches and share operational insights.
  • Help educate credentialing associates as new processes and payers are introduced.

Rula is a remote-first company that makes mental health care more accessible by streamlining provider onboarding. The team values diversity, equity, and inclusion, fostering a culture of belonging.

US Unlimited PTO

  • Manage end-to-end credentialing and payer enrollment activities with minimal supervision.
  • Ensure provider readiness, accurate records, and compliant documentation across multiple systems.
  • Serve as a knowledgeable resource for less experienced team members and support cross-functional processes.

Our partner is a healthcare organization focused on credentialing and provider network management. They offer a mission-driven, inclusive environment with a focus on collaboration and continuous learning.

US

  • Verify healthcare providers' education, licenses, and credentials to ensure patients receive care from qualified professionals.
  • Maintain accurate records, track expiration dates, and ensure compliance with accrediting bodies and insurance companies.
  • Work closely with partners to deliver personalized service, coach team members, and lead by example.

Main Street Health is the nation's largest provider of value-based care exclusively serving rural America. We partner with rural health systems to bring high-quality care to patients, fostering a culture of entrepreneurial spirit, adaptability, and down-to-earth teamwork.

US Unlimited PTO

  • Collect, verify, and maintain provider credentials such as education, licensure, and malpractice insurance.
  • Enroll providers with Medicare, Medicaid, and commercial insurance payers.
  • Maintain provider profiles in CAQH and track credential expiration dates for timely renewals.

Foodsmart is a telenutrition and foodcare solution backed by a network of Registered Dietitians, guiding 2.2 million members toward healthier food choices. The company is a remote-first team with a mission-driven culture and recently secured a $200 million investment from TPG's Rise Fund.

US

  • Manage the end-to-end credentialing process for assigned therapists, ensuring compliance with all requirements.
  • Review credentialing documents, complete primary source verifications, and maintain accurate records in multiple systems.
  • Partner with cross-functional teams to resolve issues and support timely onboarding.

Luna is revolutionizing the delivery of physical therapy by providing in-home care. The company is a start-up with a supportive leadership culture that offers opportunities for growth.

US Unlimited PTO

  • Credential providers end-to-end, managing high volumes of caseloads.
  • Pioneer best practices and new workflows for provider credentialing.
  • Collaborate cross-team to improve processes and policies.

Verifiable is a provider credentialing and network monitoring platform delivering AI, API, and software solutions to healthcare organizations. The company has grown to ~150 employees in 5 years, with a collaborative, high-ownership culture.

US

  • Lead and develop a credentialing team, overseeing provider credentialing, licensing, and privileging processes.
  • Manage operational workflows, conduct audits, and implement improvements to ensure compliance and efficiency.
  • Collaborate with internal leadership, providers, and external clients to resolve issues and maintain high service levels.

Jobgether is an AI-powered recruitment platform that connects candidates with job opportunities through objective matching. It offers a fully remote, collaborative work environment with a focus on employee development and belonging.

  • Coordinate credentialing, payer enrollment, and recredentialing for clinicians.
  • Maintain provider data across CAQH, NPPES, PECOS, and payer portals.
  • Track contracts, follow up with payers, and escalate delays to ensure billing readiness.

Legion Health is a full-stack, AI-native psychiatry network delivering mental health care at scale. It's a fast-paced startup focused on using AI to automate care operations, with a culture of adaptability and process improvement.

US

  • Oversee the processing of initial payer applications to ensure compliance with accreditation standards and regulations.
  • Maintain and manage payer credentialing databases with accuracy and audit readiness.
  • Supervise payer credentialing staff by coordinating workloads, providing training, and monitoring performance.

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. They serve facilities across the United States, offering multispecialty physician services, telemedicine, and remote patient monitoring.

US

  • You compile and maintain current and accurate data for dentists.
  • You complete credentialing and re-credentialing applications and monitor follow-ups.
  • You maintain copies of licenses, certifications, and other required documents.

We are a dental partnership organization dedicated to preserving the integrity of private practice. We currently serve patients in Oklahoma, Arkansas, Kansas, Missouri, and Nebraska and value team members who are motivated and detail-oriented.

US

  • Process state medical licenses for clinical professionals across multiple states.
  • Manage the full application lifecycle with medical boards, vendors, and clinicians.
  • Handle controlled substance, DEA, and malpractice insurance applications.

Curana Health is a national leader in value-based care for senior living communities, offering on-site primary care services and Medicare plans. Founded in 2021, it serves over 200,000 seniors across 1,500+ communities with more than 1,000 clinicians and was ranked #147 on the Inc. 5000.

$80,000–$90,000/yr
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  • Own the licensing vendor relationship and budget, directing vendor performance and holding them accountable.
  • Manage payer credentialing end to end, ensuring providers are enrolled and revenue-ready.
  • Own payer roster management and develop relationships with payer representatives to resolve issues.

Brightline provides pediatric behavioral health care via virtual and in-person services, including therapy and psychiatry for kids up to age 18. Founded in 2019, the company has served tens of thousands of families and is nationally recognized for clinical excellence.

Global

  • Manage electronic provider records to ensure accuracy, timeliness, and compliance with internal and external standards.
  • Handle licensing applications including DEA, CSR, and state licensure from start to finish, coordinating with providers and boards.
  • Communicate effectively with providers, state licensing boards, and agencies to facilitate timely credentialing and renewals.

Sevaro is a leading tele-neurology company that focuses on delivering innovative healthcare solutions to patients across the globe. The company culture emphasizes efficiency, compliance, and proactive collaboration in medical staff services.

US

  • Submit and track provider enrollments with Medicare, Medicaid, and major commercial payers.
  • Maintain and update credentialing databases and payer status logs.
  • Collaborate with credentialing team and payer representatives to resolve blockers and shorten approval timelines.

Big Leap is a fast-growing, multi-state medical & behavioral clinician group focused on interventional mental health treatments like Spravato & TMS. The company is expanding its remote operations team to support growth.

US

  • Own and manage multi-state provider licensing, ensuring zero lapsed licenses.
  • Run the full new-state licensing process, including vendor and board communication.
  • Maintain a real-time system of record for provider license status and compliance.

Honeydew builds clinical infrastructure to connect patients with providers quickly and reliably. They have helped over 40,000 patients and are growing 5x year over year.

US

  • Submit provider and organizational contract requests to commercial, Medicare, Medicaid, and managed care payers.
  • Monitor contract application status and maintain detailed tracking of all submissions and negotiations.
  • Coordinate with internal teams to facilitate successful implementation of newly executed agreements.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and maintain a fully remote culture focused on collaboration and personal connection.

US

  • Guide learners through third-party vendor accounts, documentation, and background checks.
  • Monitor learner progress for large cohorts and implement corrective actions.
  • Support training and mentoring of Specialists I and II.

Nightingale Education Group focuses on higher learning in healthcare professions, elevating education, health, and employment systems. They have graduated nearly 5,000 nurses and serve diverse communities with a blended-distance learning platform.

$75,000–$105,000/yr
US 3w PTO

  • Manage client medical payment policies to ensure accuracy and compliance with CMS and payer guidelines.
  • Conduct periodic reviews and analyses of policy updates, coordinating with Medical Directors and presenting recommendations to clients.
  • Serve as the primary client liaison, addressing inquiries and maintaining detailed documentation of policy nuances.

Cotiviti is a healthcare data analytics company specializing in payment accuracy and medical policy management. The company fosters a collaborative remote culture and offers competitive benefits to support its team.

$145,000–$155,000/yr
US

  • Lead the strategy to secure national payor agreements, moving from state-by-state enrollment to national in-network contracts with major commercial payors.
  • Manage a Credentialing Specialist, setting SLAs and KPIs for credentialing turnaround time, while overseeing payor enrollment and claim denial resolution.
  • Partner with Clinical Ops and Revenue Cycle to align provider onboarding with credentialing lead times and national agreement rollouts.

Happy Health is revolutionizing sleep medicine delivery through a comprehensive telehealth platform that eliminates traditional barriers to sleep care. The company is a fast-moving, low-ego team that values ownership and problem-solving over process, operating remotely with a physical office in Austin, TX.

Philippines

  • Maintain accurate caregiver supervision records within HHA Exchange (HHAX) and ensure proper documentation of nursing supervisory visits.
  • Update caregiver compliance profiles, upload supervision forms, and verify documentation for accuracy and completeness.
  • Communicate with clinical staff regarding incomplete documentation and assist with audits and compliance-related tasks.

Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic healthcare facilities. They leverage a global network to connect clients with qualified professionals, offering tailored services to meet unique business needs.