As a Credentialing Associate, you will play a vital role in helping mental health providers get credentialed with insurance payors—especially Medicare and commercial plans—so they can begin delivering care quickly and effectively. You’ll serve as a key point of contact for both providers and payors, managing application workflows, conducting primary source verification, and ensuring accurate provider information in internal and external systems like CAQH.
Complete requests for Medicare, private insurance and hospital credentialing for numerous physicians and mid-level practitioners in various states. Manage a detailed tracking system for completed and pending credentialing assignments. Maintain practitioner credentialing and licensing files by documenting all tasks in the database. Manage provider contracts, fee schedules and contract manager relationships. Respond to internal and external requests and prepare status reports.
As Payer Enrollment Manager, you’ll be a key leader in our credentialing and compliance operations, overseeing delegated and non-delegated credentialing processes, managing payer enrollment workflows, and ensuring we meet accreditation and contractual requirements. This role requires close collaboration with internal stakeholders and external payer partners to scale processes, maintain compliance, and drive operational efficiency.