Contracting and Credentialing Specialist – Mental Health Care

This is a fully remote position, open to applicants in Dominican Republic.

📋 Description

• Take charge of the entire process of provider credentialing and payer contracting.

• Keep credentialing files up to date.

• Prepare and monitor applications for credentialing and re-credentialing.

• Assess and negotiate payer contracts.

• Address any discrepancies in enrollment and contracting.

• Offer limited assistance with billing tasks.

• Ensure that providers remain fully credentialed and that payer contracts are compliant.

⛳️ Requirements

• A minimum of 2 years of experience in healthcare contracting, credentialing, or revenue cycle management.

• Practical experience in preparing, submitting, and tracking credentialing and re-credentialing applications with insurance payers and networks.

• A solid understanding of insurance verification, payer enrollment, and provider data management.

• Experience in reviewing, negotiating, and managing payer contracts, including monitoring expiration dates and renewal schedules.

• Proficient in using credentialing software platforms and Microsoft Office.

• Familiarity with healthcare operations from both the payer and provider perspectives.

• C1+ English proficiency (CEFR) for effective communication and contract negotiation with payers.

• Nice-to-Have

• Experience in Applied Behavior Analysis (ABA) or behavioral health environments.

• Knowledge of CAQH, NPI registry, and insurance payer portals.

• Experience with medical billing or claims follow-up within a revenue cycle team.

• Proven history of improving processes in credentialing or contracting workflows.

🏝️ Benefits

• Competitive Salary: Based on experience and skills.

• Remote Work: Fully remote—work from anywhere.

• Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting.

• Generous PTO: In accordance with company policy.

• Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees.

• Direct Mentorship: Guidance from international industry experts.

• Learning & Development: Ongoing access to resources for professional growth.

• Global Networking: Connect with professionals worldwide.