Contracting and Credentialing Associate

Location

Worldwide

Posted

5 days ago

Salary

$600 - $900 / month

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Contracting and Credentialing Associate

Autism Diagnosis Group

• Manage end-to-end credentialing and re-credentialing processes for Clinical Psychologists (PsyD/PhD), therapists (LCSWs, LPCs, LMHCs) and other remote clinical providers • Maintain and audit all provider profiles in CAQH, ensuring information is current, attested, and fully compliant • Perform primary source verifications of provider licenses, certifications, education, and malpractice insurance history • Maintain secure, centralized physical and digital provider credentialing files, fee schedules, and databases • Prepare, submit, and track provider enrollment applications with payers • Compile and distribute monthly provider rosters to active insurance plans to ensure payer directories remain accurate • Identify and resolve provider-level NPI, taxonomy, or enrollment errors that cause clearinghouse or payer-level claim rejections • Actively track credentialing cycle times and report on application statuses across our active expansion pipeline • Monitor contracting pipelines, ensuring group contract addendums and provider agreements are executed correctly • Support the operations team by gathering data and preparing applications to challenge commercial panel closures (network adequacy appeals) • Regularly audit payer directories to ensure Josi Health providers are visible and active • Monitor licensure and certification expiration dates (e.g., state medical licenses, DEA, malpractice) and send timely renewal alerts to providers • Collaborate closely with recruiting and clinical teams to coordinate the onboarding schedule of incoming providers • Adhere strictly to NCQA standards, URAC guidelines, and HIPAA regulations regarding data security and privacy • Provide clear, professional updates to providers on their credentialing status, making document retrieval as painless as possible

Job Requirements

  • 2+ years of healthcare experience specializing in provider credentialing, payer enrollment, or provider relations
  • Highly proficient with CAQH
  • Working knowledge of medical licensing structures (e.g., PsyPact), NPI registries (NPPES), and primary source verification standards
  • Obsessive attention to detail – a missed box or expired license can disrupt operations; you double-check everything
  • Excellent written and verbal English communication skills; comfortable reaching out to busy providers and navigating complex payer customer service lines
  • Strong spreadsheet skills (Excel/Google Sheets) for tracking active pipelines and provider cohorts
  • Reliable remote work setup with backup power and high-speed internet (aligned with EST hours)

Benefits

  • Fully remote – work from anywhere outside the US
  • Competitive monthly compensation in USD
  • Direct ownership of a vital operational pipeline in a fast-scaling startup
  • Support from a collaborative, tech-forward administrative team

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