Contracting and Credentialing Associate – Non-US
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Job Description
Contracting & Credentialing Associate managing healthcare provider enrollment and credentialing processes for remote telehealth providers. Ensuring compliance and efficiency in a fast-growing healthcare company.
Responsibilities:
- Manage end-to-end credentialing and re-credentialing processes for Clinical Psychologists (PsyD/PhD), therapists (LCSWs, LPCs, LMHCs) and other remote clinical providers
- Maintain and audit all provider profiles in CAQH, ensuring information is current, attested, and fully compliant
- Perform primary source verifications of provider licenses, certifications, education, and malpractice insurance history
- Maintain secure, centralized physical and digital provider credentialing files, fee schedules, and databases
- Prepare, submit, and track provider enrollment applications with payers
- Compile and distribute monthly provider rosters to active insurance plans to ensure payer directories remain accurate
- Identify and resolve provider-level NPI, taxonomy, or enrollment errors that cause clearinghouse or payer-level claim rejections
- Actively track credentialing cycle times and report on application statuses across our active expansion pipeline
- Monitor contracting pipelines, ensuring group contract addendums and provider agreements are executed correctly
- Support the operations team by gathering data and preparing applications to challenge commercial panel closures (network adequacy appeals)
- Regularly audit payer directories to ensure Josi Health providers are visible and active
- Monitor licensure and certification expiration dates (e.g., state medical licenses, DEA, malpractice) and send timely renewal alerts to providers
- Collaborate closely with recruiting and clinical teams to coordinate the onboarding schedule of incoming providers
- Adhere strictly to NCQA standards, URAC guidelines, and HIPAA regulations regarding data security and privacy
- Provide clear, professional updates to providers on their credentialing status, making document retrieval as painless as possible
Requirements:
- 2+ years of healthcare experience specializing in provider credentialing, payer enrollment, or provider relations
- Highly proficient with CAQH
- Working knowledge of medical licensing structures (e.g., PsyPact), NPI registries (NPPES), and primary source verification standards
- Obsessive attention to detail – a missed box or expired license can disrupt operations; you double-check everything
- Excellent written and verbal English communication skills; comfortable reaching out to busy providers and navigating complex payer customer service lines
- Strong spreadsheet skills (Excel/Google Sheets) for tracking active pipelines and provider cohorts
- Reliable remote work setup with backup power and high-speed internet (aligned with EST hours)
- Experience credentialing remote/telehealth providers across multiple states (Preferred)
- Familiarity with NCQA credentialing standards, PECOS, and various state Medicaid portals (Preferred)
- Experience in behavioral health networks (Preferred)
- Certified Provider Credentialing Specialist (CPCS) certification (Preferred).
Benefits:
- Fully remote – work from anywhere outside the US
- Competitive monthly compensation in USD
- Direct ownership of a vital operational pipeline in a fast-scaling startup
- Support from a collaborative, tech-forward administrative team
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