Offer summary

Qualifications:

Prior experience in credentialing in California, with knowledge of Medicare, Medi-Cal, and commercial insurance payer requirements., Highly organized and detail-oriented with strong follow-through skills., Experience using CAQH, PECOS, and payer portals is essential., Excellent communication and problem-solving skills are required..

Key responsabilities:

Complete credentialing and enrollment for newly hired providers with all contracted payers.

Maintain and update CAQH profiles for all providers on a quarterly basis.

Ensure provider state licenses, DEA, NPI, and other certifications remain current and are renewed on time.

Communicate with payers and follow up on application statuses to ensure timely enrollment.

Job description

This is a remote position.

Responsibilities:

Complete credentialing and enrollment for newly hired providers with all contracted payers (Medicare, Medi-Cal, and commercial insurances).
Add newly hired providers to our current malpractice insurance policy.
Maintain and update CAQH profiles for all providers on a quarterly basis or as required.
Ensure provider state licenses, DEA, NPI, and other certifications remain current and are renewed on time.
Track and update licensing and regulatory documentation for all clinic locations.
Maintain organized records and credentialing logs across all provider files.
Communicate with payers and follow up on application statuses to ensure timely enrollment.
Support audit and compliance readiness through timely and accurate documentation.

Requirements

Preferred Qualifications:

Prior experience in credentialing in California, with a strong understanding of Medicare, Medi-Cal, and commercial insurance payer requirements.
Highly organized and detail-oriented, with strong follow-through and ability to manage multiple tasks.
Experience using CAQH, PECOS, and payer portals.
Excellent communication and problem-solving skills.
Familiarity with multi-location/multi-specialty group practices is a plus.