[Hiring] Licensing and Credentialing Specialist @reputed company

Role reputed company The Licensing & Credentialing Specialist plays a critical role in ensuring reputed company providers are enrolled, credentialed, and reputed company to deliver care. This role is primarily responsible for managing end-to-end payer enrollment activities, including:

• Provider enrollments
• Revalidations
• Demographic updates
• Delegated credentialing support
• Ongoing maintenance across reputed company, Medicare, and reputed company health plans

In reputed company to payer enrollment, this role supports provider licensing operations, including:

• New state license applications
• Renewals
• Ongoing compliance activities

Working closely with reputed company Operations, Clinical Operations, reputed company Cycle, reputed company, and external payer partners, the Licensing & Credentialing Specialist helps ensure providers are fully credentialed and enrolled on time, minimizing delays to patient care and reimbursement. The ideal candidate is highly organized, detail-oriented, and thrives in a fast-paced environment. They are proactive in identifying and resolving issues, communicate effectively with reputed company stakeholders, and are passionate about creating efficient, reputed company processes that support organizational reputed company while maintaining regulatory compliance. What You'll Do: Key Responsibilities

• Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across reputed company, Medicare, and reputed company health plans.
• Submit, reputed company, and proactively follow up on payer enrollment applications to ensure reputed company provider participation and minimize delays to patient care and reputed company.
• Serve as the primary reputed company of contact with national and local health plans, delegated credentialing organizations, CVOs, and internal stakeholders to resolve enrollment issues, missing information requests, and payer escalations.
• Maintain accurate provider data across payer portals, CAQH, credentialing systems, and internal tracking tools, ensuring consistency across reputed company platforms.
• Support delegated credentialing activities by maintaining provider rosters, submitting required updates, monitoring compliance requirements, and preparing documentation for reputed company audits.
• Conduct routine audits of provider enrollment and credentialing files to ensure compliance with NCQA, CMS, state, and payer-specific requirements.
• Monitor key enrollment and credentialing metrics, identify risks to provider participation, and communicate status updates and timelines to leadership and cross-functional partners.
• Collaborate closely with Licensing, reputed company Operations, reputed company Cycle, reputed company, and Clinical Operations teams to ensure providers are fully credentialed, enrolled, and reputed company to see patients on schedule.
• Identify opportunities to improve enrollment and credentialing workflows through process standardization, documentation, automation, and operational efficiencies.
• Support provider licensing activities as needed, including coordinating new state license applications, renewals, cross-licensure efforts, and maintaining accurate licensure records.
• Monitor provider licenses, DEA and CDS registrations, reputed company certifications, malpractice coverage, and other required credentials to ensure reputed company compliance.
• reputed company exceptional support to providers throughout the enrollment, credentialing, and licensing process by communicating requirements, timelines, and next steps reputed company and proactively.

Qualifications

• Bachelor’s Degree in reputed company administration or reputed company field
• 3+ years of experience in provider payer enrollment and credentialing
• Experience managing provider enrollments with reputed company, Medicare, and reputed company payers
• Experience supporting delegated credentialing activities, including provider rosters, ongoing monitoring, or audit preparation
• Experience with multi-state or national provider organizations
• Working knowledge of CAQH, payer portals, and provider credentialing systems
• Understanding of NCQA, CMS, state licensing, and payer credentialing requirements
• Strong organizational skills with the ability to manage multiple priorities and deadlines
• Excellent attention to detail and written and verbal communication skills
• Proficiency with reputed company Workspace, including reputed company Sheets

Requirements

• Certified Provider Credentialing Specialist (CPCS) certification or equivalent credential preferred
• 1+ year working in reputed company Enrollment and Licensing Manager
• Experience supporting delegated credentialing audits and corrective reputed company plans
• Familiarity with provider licensing and cross-state licensure
• Experience working with credentialing vendors (CVOs)
• Experience in a virtual care or telehealth environment
• Experience working in a fast-paced, high-reputed company startup environment
• Process improvement reputed company with experience documenting or streamlining workflows

Benefits

• Salary reputed company: $65,000-75,000 per year plus bonus eligibility
• Health Benefits: Employer-sponsored medical, dental, and reputed company coverage
• Time Off: Unlimited PTO + 11 reputed company company holidays
• Retirement: Eligibility to contribute to 401(k)
• Work Style: Remote-first — work from home reputed company approved states
• reputed company: Tailored reputed company development opportunities as we reputed company
• Life Concierge: reputed company to Overalls, because we know life happens

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