Credentialing Specialist - ZR_30438_JOB

This is a remote position.

• Contract type: Independent Contractor
  
• Night Shift Schedule: Monday to Thursday - 8:45am to 5pm New York Time (8:45pm - 5am Manila Time)
  
• Friday - 8:45am to 3:45pm New York Time (8:45pm - 3:45am Manila Time)
  

• 100% verification of required data: All client required information is confirmed prior to initiating enrollment applications.
  
• Submission timeliness: New provider applications are submitted within 8 working hours of receiving complete information.
  
• Applications for new payor contracts are submitted within 3–5 business days of receiving complete information.
  
• Proactive communication: Daily activity and followup reports are consistently sent to the Credentialing Representative II or State Payor Credentialing Coordinator.
  
• Application accuracy: Application denial rate remains below 1% across all submissions.
  

• Lead the submission of provider enrollment applications for assigned states with complex regulations or high provider volume.
  
• Serve as the primary subject matter expert for credentialing and enrollment requirements in assigned state(s).
  
• Maintain current knowledge of both In-network and out-of-network enrollment processes.
  
• Partner with Account Coordinators to validate provider data and documentation prior to initiating enrollment applications.
  
• Establish and maintain productive working relationships with payor representatives in assigned states to support clear communication and timely issue resolution.
  
• Prepare and submit provider enrollment documentation through appropriate channels, including payor portals and mailed submissions.
  
• Track application status and perform proactive followups to drive timely approvals.
  
• Manage re-credentialing submissions and communicate upcoming client requirements to Account Management.
  
• Complete quarterly and other required payor attestations to ensure ongoing compliance.
  
• Provide daily status reports to Credentialing Coordinator, including updates for personal workload and any Credentialing Representative I staff supporting assigned states.
  
• Maintain thorough documentation of all submissions, followups, and payor correspondence within internal tracking systems.
  

Requirements

Knowledge/skills/abilities:

• Exceptional attention to detail and strong organizational skills.
  
• Critical thinking and problem-solving abilities in complex or ambiguous situations.
  
• Ability to work effectively in a fast-paced, deadline-driven environment.
  
• Clear and professional verbal and written communication skills.
  
• Strong reading comprehension and ability to interpret regulatory and procedural guidance.
  
• Professional yet assertive communication style when working with payors to drive timely outcomes.
  

Education/experience required:

• At least 2 years in college
  
• Two years experience in US-based medical billing practice or 
  
• Two years experience in a medical practice dealing with billing including but not limited to, provider credentialing, authorizations, reimbursement, etc. preferably in Behavioral Health to some degree
  

MBH Core Values: We hire/fire/promote based on these core values + job-specific performance:

1. Respectful of our unique cultural environment 
   
2. Absolute Confidentiality 
   
3. Embracing Teamwork
   
4. Loyal Behavior & Positive Attitude
   
5. Accountability 
   
6. Proactiveness 
   
7. Thoroughness 
   
8. Focused on results
   
9. Inspired to learn & grow constantly 
   
10. Devoted to providing top-tier services to our clients through the "Unique Service Oriented Philosophies"
    

Benefits

• Permanent work from home
  
• Immediate hiring
  
• Steady freelance job
  
• Profit sharing incentive
  
• Paid time off
  
• Holiday pay
  
• Annual Performance and Raise Evaluation
  
• Quarterly Perfect Attendance Incentive
  
• HMO
  
• BruntWork Loan Assistance