Credentialing Specialist (Mental Health Providers – U.S. Insurance)

We are looking for a skilled Credentialing Specialist to help us onboard our new mental health provider/s. This role will be responsible for the complete credentialing and enrollment process with US health insurance plans (e.g., Medicare, Tricare, Aetna, Cigna, UHC, BCBS) in accordance with regulatory requirements and must ensure timely onboarding of our provider/s into applicable networks.

Responsibilities

• Conduct primary source verification of licenses, education, training, malpractice coverage, NPI, DEA, and board certifications.
• Maintain compliance with NCQA, URAC, CMS, and state regulatory requirements.
• Monitor and track credentialing statuses, expirations, and renewal deadlines.
• Communicate with providers to obtain required documentation and resolve discrepancies.
• Coordinate with insurance payers, managed care organizations, and credentialing committees to facilitate timely approvals.
• Maintain accurate credentialing logs, spreadsheets, and internal databases.
• Support provider onboarding processes and ensure credentialing requirements are met prior to activation.

Qualifications

• Minimum of 1–3 years of experience in credentialing, provider enrollment, or healthcare compliance; behavioral health experience strongly preferred.
• CPCS or CPMSM certification preferred but not required.
• Knowledge of NCQA and URAC accreditation standards.
• Knowledge of CAQH, NPI, Medicare/Tricare/Headway enrollment, and commercial payer credentialing requirements.
• Strong understanding of mental health licensure types and scope of practice across U.S. states.
• Proficiency in Google Workspace.
• Excellent organizational skills with strong attention to detail and accuracy.
• Ability to maintain confidentiality and handle sensitive information in accordance with HIPAA and company policies.

How to apply
Please include your years of experience as a Credentialing Specialist in the subject line. If you do not have the required experience, please do not apply. Make sure to attach your resume to your message. Only responses on OnlineJobs.ph will be considered. This is a project-based position. We offer $50/insurance per provider, and we’ll add 25% bonus if everything is set up and ready to go in < 45 days.