Credentialing and Licensing Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $26 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 5%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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BetterHealth

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2014

🏥 Healthcare

🧘 Wellness

👥 B2C

Healthcare • Wellness • B2C

BetterHealth is a forthcoming consumer-facing health and wellness website using the Philippine domain betterhealth. ph. The site currently displays a "Launching Soon" landing page with an email sign-up for updates and promotions, a contact form, cookie and reCAPTCHA notices, and a 2026 copyright. Public information is limited; no specific products or services are listed yet, but the branding and site content indicate a focus on health/wellness for consumers in the Philippines.

📋 Description

• Oversee credentialing, recredentialing, and health plan or hospital privileging processes for physicians and qualified healthcare professionals • Ensure physicians are privileged when required by individual health plans • Maintain and monitor facility credentialing for ambulatory surgical centers, pharmacies, and laboratories • Perform credentialing and licensing duties with expertise, consistency, and quality • Compile and maintain current and accurate electronic provider data • Complete and maintain ARMS credentialing and recredentialing for organizations using BetterHealth’s services • Apply for ARMS malpractice coverage for new APRNs, PAs, and physicians, including offsite emergency coverage for physicians • Review provider malpractice coverage annually • Maintain documentation in third-party systems such as Modio and CredentialSmart for primary source verification • Create, update, and maintain CAQH ProView accounts; acquire accounts for new providers • Obtain, update, and maintain NPPES/PECOS accounts for APRNs, PAs, and physicians • Maintain electronic copies of licenses, board certifications, DEA registrations, required certificates, malpractice coverage, and other credentialing documents • Obtain electronic signatures for new providers • Complete, monitor, and follow up on credentialing and recredentialing applications with commercial, Medicaid, Medicare, and Medicaid managed care payers • Provide payers with demographic updates when providers are added or terminated • Maintain electronic folders of signed physician contracts and archived contracts • Manage confidentiality of provider and corporate information for federal and state agencies • Assist with revenue cycle processes including appeals, billing, follow-up, insurance benefit verification, payment posting, self-pay collections, and customer service • Demonstrate effective customer service and communication with internal teams and affiliate clients • Work as a self-starter with minimal direction • Perform other duties as assigned • Travel throughout and between facilities as needed

🎯 Requirements

• High school diploma or GED • Minimum of three years direct experience with credentialing providers in a medical practice • Knowledge and understanding of credentialing processes with health insurance plans • Experience using CAQH ProView • Experience working with state Medicaid plans • Ability to handle highly confidential and sensitive matters and documents • Ability to define problems, collect data, establish facts, and draw valid conclusions • Knowledge of business practices and protocols • Ability to handle multiple priorities and projects • Ability to work with minimal direction • Excellent time management and organizational skills • Adaptability and flexibility with changing end-user business needs • Willingness to learn new software and systems • Understanding of racial inequity and its impact on healthcare systems and institutions

🏖️ Benefits

• Less than 5% travel required • Reasonable accommodations for individuals with disabilities