Provider Credentialing Specialist – (Remote)
Rate: $4.5/hr

We are seeking an experienced and detail-oriented Provider Credentialing specialist to support our mental health group practice. This role is crucial in ensuring that our therapists, counselors, and other mental health professionals are properly credentialed with insurance companies, regulatory bodies, and other relevant organizations.

The ideal candidate has experience in provider credentialing, understanding insurance panel complexities, and knowledge of mental health regulations in Florida.

Before Applying

To validate your application, complete the following assessments:

Strength Test: https://high5test.com/
Personality Test: https://www.16personalities.com/

Once done, send your test results to cservice@cooblueva.com with the subject line:
📩 PERSONALITY AND STRENGTH TEST RESULT – [Your Full Name]

Key Responsibilities

Manage the full credentialing lifecycle for mental health providers, including initial credentialing, re-credentialing, and privileging.
Verify and maintain accurate records for provider qualifications (licensure, certifications, malpractice insurance, and continuing education).
Coordinate with providers to collect necessary documentation and ensure timely submission to insurance companies and credentialing entities.
Work directly with insurance companies and CAQH to facilitate provider enrollment and network participation.
Ensure compliance with NCQA, URAC, and other accreditation standards related to mental health services.
Communicate with providers regarding credentialing status, documentation needs, and follow-ups.
Stay updated on mental health regulations, payer requirements, and evolving credentialing standards.
Resolve credentialing-related issues, discrepancies, and disputes to avoid billing disruptions.
Track expiration dates for licenses, certifications, and insurance contracts, ensuring timely re-credentialing.
Support audits and internal reviews to maintain full compliance.
Ensure confidentiality and security of provider information per HIPAA and privacy laws.

Qualifications

HIPAA Certified.
Strong organizational skills with the ability to manage multiple tasks and meet deadlines.
Advanced English proficiency for interacting with providers, insurance companies, and internal teams.
2-5 years of experience in provider credentialing for mental health professionals (therapists, counselors, psychiatrists, psychiatric nurse practitioners, psychologists, social workers).
Knowledge of mental health insurance credentialing and payer requirements.
Familiarity with mental health-related credentials (LCSW, LPC, LMFT, PhD/PsyD, etc.).
Strong understanding of HIPAA, Medicare, and compliance regulations.
Experience with AHCA, NCQA, URAC, and mental health accreditation standards.
Proficiency in credentialing software and provider databases.
High attention to detail, accuracy, and organization.
Self-driven go-getter with the ability to work independently and take initiative with minimal supervision.

Preferred Skills

Certified Provider Credentialing Specialist (CPCS) or other credentialing certifications.
Experience working within a mental health group practice or similar clinical settings.
Experience with insurance companies like Aetna, BCBS, Cigna, Humana, Tricare, and UnitedHealthcare for mental health providers.
Knowledge of MHPAEA (Mental Health Parity and Addiction Equity Act) and mental health regulations.

Why Join Us?

✅ Work remotely with a flexible schedule.
✅ Rate starts at $4.50 per hour, based on experience.
✅ Opportunities for career growth in a growing mental health organization.
✅ Collaborative and supportive team environment.

IMPORTANT: REQUIRED FOR APPLICATION FORM SUBMISSION

This step is mandatory when completing the application form.
Please make sure to edit and use the provided resume template, ensuring that your resume highlights relevant work experience aligned with the position you are applying for.

Follow these steps carefully:

Click the resume template link:
https://www.canva.com/design/DAG9kXb5gjA/4skhrIwsMI5_fGamdUXkWA/view?utm_content=DAG9kXb5gjA&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink&mode=preview
Click “View Template.”
Log in by selecting “Continue with Google.”
Click “Open in Editor.”
Edit the template and customize it based on your relevant experience for the role.

Please Note:

We give priority to unemployed applicants. If you are currently employed and have not yet submitted your resignation, we advise you to hold off on applying at this time.