Credentialing Specialist
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Job Summary
This is a remote position.
About Insight Therapy Solutions
Insight Therapy Solutions is a growing behavioral healthcare organization providing therapy psychiatric services TMS and other mental health solutions across multiple states.
As we continue to expand were looking for an experienced Credentialing Specialist who can help ensure our providers remain credentialed contracted and ready to serve patients without interruption.
This role plays a critical part in supporting provider onboarding revenue cycle performance and organizational growth.
The Opportunity
This is an excellent opportunity for a credentialing professional who enjoys ownership organization and problem-solving.
Youll work closely with leadership clinical operations billing and provider onboarding teams to manage the full credentialing lifecycle for a growing network of behavioral health providers.
If you enjoy navigating payer requirements managing complex credentialing processes and helping healthcare organizations scale youll thrive in this role.
Perks & Benefits:
Paid Time Off (PTO 10 days annually)
Paid U.S. holidays
Paid birthday leave
Parental leave
Monthly health stipend
What Youll Be Responsible For
Provider Credentialing & Enrollment
Manage initial credentialing enrollment and recredentialing processes for providers across commercial Medicare and Medicaid payers.
Prepare submit track and follow up on credentialing applications through approval.
Coordinate provider onboarding activities related to payer enrollment and network participation.
Complete government payer revalidation and enrollment updates as required.
Database & Compliance Management
Maintain accurate provider records across CAQH PECOS NPPES CMS and other credentialing platforms.
Ensure provider files remain complete current and audit-ready.
Monitor credential expiration dates and proactively manage renewals.
Maintain credentialing documentation in accordance with payer and regulatory requirements.
Payer Relations & Contract Management
Support provider enrollment with commercial insurance plans Medicare and Medicaid.
Assist with payer communications and issue resolution.
Participate in fee schedule review and contract negotiations when applicable.
Track credentialing and enrollment statuses to minimize delays in provider activation.
Cross-Functional Collaboration
Partner with Clinical HR Billing and Operations teams to resolve credentialing-related issues impacting provider participation or reimbursement.
Communicate progress risks and timelines to managers and leadership.
Identify opportunities to improve credentialing workflows processes and tracking systems.
What Success Looks Like
Within your first year:
Provider credentialing applications are submitted accurately and completed on time.
Recredentialing and revalidation deadlines are met without lapses.
Provider onboarding timelines improve through proactive follow-up and coordination.
Credentialing-related billing denials and delays are minimized.
Leadership has clear visibility into credentialing progress and provider readiness.
Success in this role means becoming a trusted credentialing expert who helps providers join networks efficiently and supports the organizations continued growth.
What Were Looking For
Required
2 years of healthcare credentialing experience with U.S.-based healthcare organizations.
Hands-on experience with commercial payer credentialing and provider enrollment.
Experience managing CAQH PECOS NPPES CMS and related credentialing systems.
Strong understanding of Medicare Medicaid and commercial insurance credentialing processes.
Excellent organizational and documentation skills.
Strong written and verbal English communication skills.
Ability to manage multiple credentialing projects and deadlines simultaneously.
Proficiency with Google Workspace spreadsheets and credentialing databases.
Preferred
Behavioral health or mental health credentialing experience.
Multi-state credentialing experience.
Experience with fee schedule analysis or contract negotiations.
Knowledge of revenue cycle impacts related to provider credentialing.
Experience working in a remote healthcare environment.
Youll Thrive Here If You...
Enjoy working in a highly organized and detail-oriented environment.
Take ownership of tasks and follow them through to completion.
Are proactive about solving problems before they become barriers.
Communicate effectively with providers payers and internal teams.
Want to contribute to the growth of a fast-moving healthcare organization.
Required Skills:
2 years of healthcare credentialing experience with U.S.-based healthcare organizations. Hands-on experience with commercial payer credentialing and provider enrollment. Experience managing CAQH PECOS NPPES CMS and related credentialing systems. Strong understanding of Medicare Medicaid and commercial insurance credentialing processes. Excellent organizational and documentation skills. Strong written and verbal English communication skills. Ability to manage multiple credentialing projects and deadlines simultaneously. Proficiency with Google Workspace spreadsheets and credentialing databases.
