Helping older adults live happier, more fulfilling lives. Together.
Provider Enrollment, Credentialing Specialist
Location
United States
Posted
1 day ago
Salary
$50K - $70K / year
Seniority
Mid Level
Job Description
Provider Enrollment, Credentialing Specialist
Total Life
• Manage the collection, verification, and maintenance of all provider credentials, including professional licenses, board certifications, DEA registrations, and malpractice insurance. • Oversee the submission and tracking of enrollment applications for Medicare (PECOS), Medicaid, and commercial insurance panels (e.g., Humana). • Maintain and update provider profiles in the CAQH ProView database, ensuring timely re-attestations every 120 days. • Conduct thorough background checks and verify education, training, and work history to ensure compliance with NCQA and CMS standards. • Update and maintain accurate provider data within internal systems (TLOS and Healthy) to ensure the Active Care team has real-time visibility into provider capacity and expertise. • Proactively monitor and notify clinicians of upcoming license or certification expirations to prevent gaps in service or billing. • Collaborate with the Revenue Cycle Management (RCM) team to resolve claim denials related to provider credentialing or enrollment issues.
Job Requirements
- 2–6 years of experience in provider credentialing or enrollment, preferably within a behavioral health or telehealth organization.
- Demonstrated experience with the PECOS, NPPES (NPI), and CAQH portals.
- Deep understanding of the credentialing requirements for LCSWs, Psychologists, and other mental health professionals.
- Familiarity with the licensing boards and enrollment timelines for all US states
- Exceptional accuracy in data entry and a "compliance-first" mindset.
- Ability to communicate clearly and professionally with clinicians, insurance representatives, and internal stakeholders.
- Certified Provider Enrollment Specialist (CPES) or Certified Professional Credentialing Specialist (CPCS).
- Experience with credentialing software and EHR platforms.
Benefits
- Executive Partnership: Direct partnership with executive leadership to influence strategy, processes, and financial performance at an enterprise level.
- Competitive Package: Competitive compensation and benefits package.
- Purpose-Driven Work: The ability to influence the financial health of a movement dedicated to the mental wellness of the 65+ population.
- Premium Medical, Dental, and Vision insurance plans for you and your dependents.
Related Guides
Related Categories
Related Job Pages
More General Jobs
Online Tutor
Revolution PrepAn online tutoring company on a mission to change how students approach academics and high-stakes exams.
• Lead dynamic tutoring sessions, including executive function coaching (90%) • Discuss educational progress with students and families (5%) • Utilize our curated resources for stress-free planning (5%) • Commit to a minimum of one year of employment • Post at least 38 prime-time hours weekly, the same hours every week
Physical Fitness Trainer
IntellectRedefining mental health with personalised end-to-end care for workforces across Asia Pacific.
Role Description You will be a fitness trainer on our virtual platform, where your role is to support our clients' fitness and wellness journeys based on their individual needs and goals. This is delivered through scheduled video consultations on our platform. This is a freelance remote role with the flexibility to decide your business hours. Local candidates are preferred but others can still be considered. This role is a great opportunity to supplement your current job or private practice. We're seeking to partner with experienced Physical Fitness Trainers to be part of a community working collaboratively to bring greater fitness and wellness access to the public through personalized fitness coaching. What You’ll Do: - Deliver fitness training and guidance virtually to clients through both text-based consultations or video-consultations on a freelance basis. - Adapt and tailor fitness programs to meet individual client needs, taking into consideration their fitness levels, goals, and any limitations. - Collaborate on innovative fitness programs and content. - Build strong client relationships through effective communication. - Stay updated with fitness trends for continuous improvement. - Respond promptly to client inquiries, concerns, and feedback, ensuring a high level of client satisfaction and retention. Qualifications - Proven relevant work experience as a Physical Fitness Trainer. - Bachelor's degree in Exercise Science, Kinesiology, or a related field. - Able to communicate in English and local language. - Certified Personal Trainer (CPT) or equivalent certification from a recognized fitness organisation. - Excellent communication skills, both written and verbal, with the ability to simplify complex fitness concepts. - Strong content creation skills, including the ability to produce engaging video content and written materials. - Empathetic and client-focused approach to training, with a passion for helping individuals achieve their fitness goals. - Ability to work independently and collaboratively in a virtual team environment. - Proficiency in using fitness tracking software, video conferencing tools, and other relevant technology.
• eseguire campionamenti, misurazioni e inventari di serbatoi/navi a terra. • Comunicare e coordinarsi con il personale del terminal, del trasporto e della Società cliente per favorire il corretto esercizio delle mansioni assegnate. • Monitorare la disponibilità delle forniture necessarie per i processi di cui sopra e rendere note ai coordinatori le eventuali necessità di tali forniture. • Eseguire la taratura di routine delle apparecchiature, la verifica e i controlli di funzionamento. • Organizzare e coordinare i lavori in modo che i servizi siano deliverati e che i rapporti ed i campioni siano presentati in modo corretto, completo e tempestivo. • Verificare e comunicare i risultati ottenuti ed effettuare le registrazioni nei supporti appropriati, sia cartacei che elettronici, necessari per garantire la validità e la tracciabilità delle informazioni.
• Managing and coordinating customer orders from initial request through to invoicing and payment. • Preparing accurate quotations and offers for testing and product certification services. • Collaborating closely with Intertek global laboratories, external consultants, and internal functions (Sales & Marketing). • Participating in meetings and maintaining direct contact with clients, supporting them with knowledge, experience, and guidance throughout the process. • Monitoring regulatory updates, technical standards, and market developments relevant to the business. • Preparing monthly forecasts and maintaining accurate records of all ongoing activities. • Supporting the complaint handling process and contributing to issue resolution to ensure high customer satisfaction. • Providing ongoing operational support to the Testing & Inspections Manager.



