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Licensing and Credentialing Specialist
Location
United States
Posted
1 day ago
Salary
$60 - $70K / year
Seniority
Mid Level
Job Description
Licensing and Credentialing Specialist
Hey Jane
Role Description We are seeking a highly organized and detail-oriented Licensing & Credentialing Specialist who thrives in dynamic environments and is motivated by the opportunity to help clinicians deliver high-quality, patient-centered care. - Manage all aspects of provider licensing, credentialing, and payer enrollment. - Ensure our clinical team remains fully compliant, up-to-date, and able to practice without interruption. - Coordinate end-to-end licensing workflows and maintain accurate records across multiple systems. - Act as a key liaison between clinicians, state boards, payers, and internal stakeholders. - Spot gaps, create structure, and keep processes running smoothly. Responsibilities - Manage end-to-end provider licensing workflows across multiple states, including initial applications, renewals, and maintenance for all provider types (MDs, NPs, CNMs, RNs, etc.). - Own payer enrollment processes for commercial and government payers (Medicaid, Medicare), from initial application through active status. - Maintain and update CAQH profiles for all providers. - Build and maintain accurate tracking systems to monitor license and credential expiration dates. - Serve as the primary liaison between clinicians, state medical/nursing boards, payers, and internal stakeholders. - Follow up persistently and proactively with external agencies and boards to move applications forward and resolve delays. - Develop and document SOPs and workflows for licensing and credentialing processes as the company scales. - Partner closely with clinical, operations, and business development teams to ensure providers are enrolled and ready to see patients on time. - Identify gaps in current processes and implement improvements to reduce administrative burden on clinicians. - Ensure compliance with licensing requirements, credentialing standards, and HIPAA requirements. Qualifications - 2+ years of experience in provider licensing and credentialing, ideally in a telehealth or multi-state setting. - Hands-on experience with CAQH, state licensing portals, and payer enrollment systems. - Familiarity with multi-state licensing compacts (IMLC, NLC) and telehealth-specific licensing and compliance considerations. - Working knowledge of credentialing standards and government payer enrollment processes. - Exceptional organizational skills with the ability to manage a high volume of deadlines and follow-ups simultaneously. - Strong attention to detail with a track record of catching errors in complex documentation. - Proactive, persistent communicator — comfortable following up with state boards, payers, and busy clinicians. - Self-starter who can build structure and process in an ambiguous, fast-moving startup environment. - Proficiency in Google Sheets/Excel or project management tools. - High integrity and discretion when handling sensitive provider information. Requirements - Compensation: $60,000 - $70,000 a year + equity. - Remote from approved states (CA, CO, CT, DC, DE, HI, IL, MA, MD, NJ, NM, NY, OR, VT, and WA) with a strong preference in NYC. Benefits - Unlimited vacation. - Health, dental, and vision insurance with FSA.
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Role Description The Payor Enrollment Specialist is responsible for processing provider enrollment, credentialing, and re-credentialing applications while maintaining accurate provider records and managing relationships with insurance payors, healthcare facilities, and internal stakeholders. This role requires excellent attention to detail, strong follow-through, and the ability to manage multiple priorities while meeting established turnaround times and quality standards. Key Responsibilities - Provider Enrollment & Credentialing - Prepare, submit, and track provider enrollment applications for Medicaid, Managed Care, and other insurance payors. - Process credentialing and re-credentialing applications for healthcare providers. - Manage payer-specific enrollment requirements across multiple facilities and contracts. - Monitor credentialing and enrollment application statuses and follow up as needed. - Provider Data Management - Maintain provider credentialing records and databases. - Update and manage provider CAQH profiles, licensure information, board certifications, and insurance documentation. - Ensure provider rosters remain accurate and current. - Maintain CRM records, mail logs, and utility logs. - Stakeholder Communication - Build and maintain professional relationships with providers, payors, hospitals, and credentialing contacts. - Respond promptly to credentialing and enrollment requests. - Coordinate signature requests and ensure timely completion of required documentation. - Escalate unresolved provider documentation issues when necessary. - Compliance & Quality - Ensure all Protected Health Information (PHI) is handled securely and in compliance with company standards. - Support compliance initiatives by communicating credentialing issues and status updates appropriately. - Meet established accuracy and turnaround-time expectations. - Participate in credentialing committee activities as needed. Qualifications - High School Diploma or equivalent required. - 1+ years of payor enrollment experience, specifically with Medicaid and Managed Care payors. - Strong organizational skills with exceptional attention to detail. - Excellent verbal communication and professional telephone etiquette. - Proficiency with Microsoft Office applications, including Word and Excel. - Ability to manage multiple priorities while maintaining accuracy and meeting deadlines. Requirements - Some college coursework or equivalent professional experience. - Understanding of medical terminology. - CPCS (Certified Provider Credentialing Specialist) certification. - Experience maintaining provider credentialing databases and CAQH profiles. - Experience working in healthcare credentialing, enrollment, or revenue cycle operations. Benefits - A mission-based company with an amazing company culture. - Paid time off & holidays so you can spend time with the people you love. - Medical, dental, and vision insurance for you and your loved ones. - Health Savings Account (with employer contribution) or Flexible Spending Account options. - Paid Parental Leave. - Employer Paid Basic Life and AD&D Insurance. - Employer Paid Short- and Long-Term Disability. - Optional Short Term Disability Buy-up plan. - 401(k) Savings Plan, with ROTH option. - Legal Plan. - Identity Theft Services. - Mental health support and resources. - Employee Referral program – join our team, bring your friends, and get paid.
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Courtroom Presentation Specialist Chantilly, VA / Remote / Hybrid / Fairfax, VA Litigation Support / Full Time Hybrid / Hybrid Courtroom Presentation Specialist Employment Type: Full-Time, Mid-Level Department: Legal As a Courtroom Presentation Specialist, for CGS, you will be responsible for providing litigation support services to clients. The ideal candidate must be familiar with courtroom presentation packages such as Trail Director and Sanction. You will work with the trial team, including expert witnesses, to develop plans for trial or hearings using a courtroom presentation system. CGS is looking for a candidate who is ready to be part of a dynamic team and work effectively as a team member in an extremely pressured environment. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success: - Develops simple graphic images/exhibits using standard off-the-shelf software packages. - Advises attorneys on the effectiveness of certain exhibits or sequences of exhibits. - Responsible for the smooth operation of the presentation system in the courtroom. - Synchronizes clips with written transcripts. - Coordinates internal firm efforts to conduct trials remotely/virtually. Qualifications: - Bachelor’s Degree preferred, or equivalent combination of education, training, and experience. - Must be a US Citizen and able to obtain a Public Trust clearance. - Extensive trial experience required. - Must have excellent oral communication skills. - Must be able to travel to support out-of-town trial needs. Our Commitment: Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we’ve been growing our government-contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and delivering the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package. - Health, Dental, and Vision - Life Insurance - 401k - Flexible Spending Account (Health, Dependent Care, and Commuter) - Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board: https://cgsfederal.com/join-our-team/ For more information about CGS please visit: https://www.cgsfederal.com or contact: Email: info@cgsfederal.com #CJ $70,000 - $90,000 a year
