Credentialing Specialist

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Alpaca Health

WebsiteLinkedInAll Job Openings

2 - 10 employees

Founded 2024

🏥 Healthcare

👥 B2C

Healthcare • B2C

Alpaca Health is a provider network that delivers personalized Applied Behavior Analysis (ABA) therapy for children with autism spectrum disorder and developmental delays. They connect families with local, independent clinicians (BCBAs and therapists) and offer flexible care models — in-home, in-clinic, in-school, in-daycare, in-community, and virtual sessions — designed to integrate into a family’s daily routine. Alpaca Health provides diagnostic support (including free online screening tools and ADOS-2 assessments for young children), accepts many major insurance plans and is in-network with 100+ payers across states such as Texas, Colorado, North Carolina, and Hawaii.

📋 Description

• Manage provider credentialing and enrollment applications with commercial and government health plans • Submit, track, and follow up on provider credentialing and payer enrollment applications • Maintain accurate provider and enrollment information across internal systems and payer portals • Monitor application statuses, identify missing information or documentation, and resolve enrollment issues • Communicate with payers and providers to obtain required documentation and resolve credentialing discrepancies • Conduct regular follow-ups with payers to ensure applications are progressing within expected timelines • Research payer requirements, participation rules, and enrollment processes • Keep detailed records of credentialing activity, effective dates, and payer communications • Escalate complex credentialing or enrollment issues when needed • Support the Credentialing team with special projects and process improvements

🎯 Requirements

• Bachelor’s degree or equivalent experience • Previous experience in healthcare credentialing, provider enrollment, medical billing, healthcare operations, or a related field preferred • Strong understanding of provider credentialing and payer enrollment processes preferred • Excellent attention to detail and organizational skills • Strong written and verbal communication skills • Strong problem-solving and follow-through abilities • Proficient in MS Office, Google Workspace, and business systems • Comfortable working with spreadsheets, databases, and multiple web-based payer portals • Ability to manage multiple priorities and meet deadlines in a fast-paced, remote environment • Self-motivated, dependable, and comfortable working independently • Willing and able to work United States East Coast (ET) hours • Must be based in the Philippines