Job Details

Credentialing Specialist (Fully Remote)

LearnWell Behavioral Health is a multi-state behavioral health organization supporting over 400 clinicians across New York and Massachusetts. We onboard approximately 30 new providers each month and maintain active participation across Medicare, Medicaid, and commercial insurance networks.

We are seeking a Credentialing Specialist to support our provider enrollment and credentialing operations. This position plays an essential role in ensuring clinicians are properly enrolled, maintained, and compliant across multiple payer networks.

This is an entry-level opportunity for a highly organized and detail-oriented professional who is comfortable working in a structured, process-driven environment. The ideal candidate is dependable, proactive, and able to manage high volumes of administrative detail with consistency and accuracy.

What You'll Do

Provider Onboarding & Enrollment

• Complete and maintain CAQH and NPI profile updates for new clinicians.
• Support internal credentialing processes including:
• License verification
• Malpractice and liability documentation
• Resume formatting and updates
• Collection of required credentialing documents
• Submit credentialing and enrollment applications to Medicare, Medicaid, and commercial payers.
• Track submission timelines, follow-ups, and effective dates with precision.
• Follow up with clinicians for signatures and missing documentation to prevent delays.

Credentialing Maintenance & Tracking

• Maintain accurate provider data across Salesforce and Excel-based tracking systems.
• Monitor application status and proactively follow up with payer representatives.
• Verify participation status and effective dates.
• Process provider terminations and ensure removal from panels.
• Maintain organized documentation files for audit readiness.

Portal & Data Management

• Maintain CAQH attestations and document uploads.
• Manage payer portal accounts and login access.
• Conduct roster audits and reconcile discrepancies with payer directories.
• Ensure internal and external records align accurately.

Who You Are

You're someone who:

• Finds satisfaction in clean data and organized systems.
• Enjoys process-driven work and takes pride in getting details right.
• Follows up persistently until something is fully resolved.
• Can manage multiple moving pieces without losing track.
• Works independently and stays productive in a remote environment.
• Wants to grow within healthcare operations.

Qualifications

• Bachelor's degree or equivalent relevant experience.
• Strong organizational and time management skills.
• Excellent written communication and professional follow-up skills.
• Comfortable navigating multiple online portals simultaneously.
• Proficiency in Microsoft Excel.
• Familiarity with healthcare terminology (CAQH, NPI, PECOS, Medicare, Medicaid) preferred but not required.
• Ability to work independently in a fully remote environment.