Credentialing Specialist (Medical Clinic, USA)

📌 Please read before applying: A minimum of 2 years of hands-on experience in Provider Credentialing is required for this position. If you do not meet this requirement, please do not apply.

🕓 Графік: Пн-Пт, 16:00—00:00 (за Києвом)

💻 Формат: Remote

🇺🇸 Клініка: США

Ми шукаємо досвідченого Credentialing Specialist для роботи з американською медичною клінікою у сфері Mental Health / Psychiatry.

📋 Responsibilities:

✅ Prepare and submit initial credentialing and re-credentialing applications for clinical providers

✅ Manage provider enrollment with Medicaid, Medicare, commercial insurance plans, and Managed Medicaid

✅ Maintain and attest CAQH profiles and ensure provider information is accurate across CAQH, NPPES, PECOS, and payer portals

✅ Track credentialing applications, follow up with insurance companies via phone and email, and resolve delays, deficiencies, and rejections

✅ Monitor provider credentials and expiration dates, including licenses, DEA, malpractice insurance, and board certifications

✅ Complete payer enrollment for new practice locations, group NPIs, and Tax IDs, as well as change-of-information requests

✅ Verify provider participation status and effective dates and communicate updates to the billing team

✅ Perform primary source verification, including licenses, education, work history, NPDB, and OIG/SAM exclusion checks

✅ Coordinate with providers to collect required documentation, information, and signatures

✅ Maintain an accurate credentialing tracker with application statuses, deadlines, effective dates, and next steps

✅ Prepare credentialing status reports and proactively identify delays, expiring credentials, denied enrollments, and other potential issues

🎯 Кого ми шукаємо:

• 2+ роки досвіду у Provider Credentialing, бажано з insurance payers штату New York
• Практичний досвід роботи з Medicaid/eMedNY, Medicare, commercial insurance plans та Managed Medicaid
• Досвід credentialing у сфері Mental Health / Behavioral Health буде значною перевагою
• Знання CAQH ProView, PECOS, NPPES, OPRA та payer portals
• Розуміння provider enrollment, re-credentialing та payer credentialing processes
• Англійська — B2+, впевнена письмова та усна комунікація
• Висока уважність до деталей та організованість
• Вміння одночасно контролювати велику кількість applications, deadlines та follow-ups
• Аналітичне мислення, відповідальність та здатність самостійно вирішувати проблеми

💰 Оплата та умови:

• Ставка: $7−9/год залежно від досвіду
• Орієнтовний дохід: $1300−1600/місяць (full-time)
• Оплачуваний тренінг 📚

⭐ Why Join Us?

You’ll join a supportive international team and work directly with U.S. healthcare credentialing processes. This role offers hands-on experience with multiple insurance payers, provider enrollment systems, and credentialing workflows while giving you the opportunity to strengthen your expertise in the U.S. healthcare industry.

📩 If you already have hands-on credentialing experience and are looking for a long-term opportunity to grow your expertise in U.S. healthcare, we’d love to hear from you.

Send us your CV — we’re excited to meet you! 🌍💙