Autism Diagnosis Group

Associate

• Manage end-to-end credentialing and re-credentialing processes for Clinical Psychologists (PsyD/PhD), therapists (LCSWs, LPCs, LMHCs) and other remote clinical providers
• Maintain and audit all provider profiles in CAQH, ensuring information is current, attested, and fully compliant
• Perform primary source verifications of provider licenses, certifications, education, and malpractice insurance history
• Maintain secure, centralized physical and digital provider credentialing files, fee schedules, and databases
• Prepare, submit, and track provider enrollment applications with payers
• Compile and distribute monthly provider rosters to active insurance plans to ensure payer directories remain accurate
• Identify and resolve provider-level NPI, taxonomy, or enrollment errors that cause clearinghouse or payer-level claim rejections
• Actively track credentialing cycle times and report on application statuses across our active expansion pipeline
• Monitor contracting pipelines, ensuring group contract addendums and provider agreements are executed correctly
• Support the operations team by gathering data and preparing applications to challenge commercial panel closures (network adequacy appeals)
• Regularly audit payer directories to ensure Josi Health providers are visible and active
• Monitor licensure and certification expiration dates (e.g., state medical licenses, DEA, malpractice) and send timely renewal alerts to providers
• Collaborate closely with recruiting and clinical teams to coordinate the onboarding schedule of incoming providers
• Adhere strictly to NCQA standards, URAC guidelines, and HIPAA regulations regarding data security and privacy
• Provide clear, professional updates to providers on their credentialing status, making document retrieval as painless as possible

Contracting and Credentialing Associate – Non-US