Licensing and Credentialing Specialist

This is a fully remote position, open to applicants in California, +8 more states.

📋 Description

• Oversee complete provider licensing workflows across various states, encompassing initial applications, renewals, and ongoing maintenance for all provider categories (MDs, NPs, CNMs, RNs, etc.)

• Manage payer enrollment procedures for both commercial and government payers (Medicaid, Medicare), from the initial application to achieving active status

• Update and maintain CAQH profiles for all providers

• Create and uphold precise tracking systems to monitor license and credential expiration dates, guaranteeing no lapses in provider practice capabilities

• Act as the main liaison among clinicians, state medical/nursing boards, payers, and internal stakeholders

• Consistently and proactively follow up with external agencies and boards to expedite applications and address any delays

• Develop and document Standard Operating Procedures (SOPs) and workflows for licensing and credentialing processes as the organization expands

• Collaborate closely with clinical, operations, and business development teams to ensure providers are enrolled and prepared to see patients promptly

• Identify inefficiencies in existing processes and implement enhancements to alleviate the administrative burden on clinicians

• Ensure adherence to licensing requirements, credentialing standards, and HIPAA regulations

⛳️ Requirements

• A minimum of 2 years of experience in provider licensing and credentialing, preferably within a telehealth or multi-state environment

• Practical experience with CAQH, state licensing portals, and payer enrollment systems

• Knowledge of multi-state licensing compacts (IMLC, NLC) and telehealth-related licensing and compliance considerations

• Understanding of credentialing standards and government payer enrollment procedures

• Outstanding organizational skills with the capacity to manage a high volume of deadlines and follow-ups concurrently

• Exceptional attention to detail, demonstrated by a history of identifying errors in intricate documentation

• Proactive and persistent communicator — comfortable with following up with state boards, payers, and busy clinicians

• Self-motivated individual who can establish structure and processes in a dynamic, fast-paced startup environment

• Proficient in Google Sheets/Excel or project management tools

• High levels of integrity and discretion when handling sensitive provider information

🏝️ Benefits

• Unlimited vacation

• Health, dental, and vision insurance with FSA