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Credentialing Specialist – Part-time
Insight Therapy SolutionsCredentialing Specialist managing payer enrollment and recredentialing for Insight Therapy Solutions’ U.S. telehealth mental-health providers.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare credentialing processes, including managing CAQH, PECOS, NPPES, and CMS systems. Proficient in coordinating provider enrollment and maintaining compliance with payer and regulatory requirements.
Highest-signal resume keywords
Healthcare Credentialing ExperienceCommercial Payer CredentialingCAQH ManagementMedicare and Medicaid KnowledgeGoogle Workspace Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Credentialing ProcessesProvider EnrollmentDocumentation ManagementFee Schedule AnalysisContract NegotiationsMulti-State CredentialingCredentialing Workflow ImprovementCredentialing Database ManagementAudit-Ready DocumentationCredential Expiration Management
Soft Skills
Organizational SkillsWritten CommunicationVerbal CommunicationProject ManagementIssue Resolution
Tools & Technologies
Google WorkspaceCredentialing DatabasesCAQHPECOSNPPESCMS
Industry Keywords
Healthcare OrganizationsBehavioral Health CredentialingRemote Healthcare EnvironmentRevenue Cycle ManagementPayer Communications
About the role
Key responsibilities & impact- 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
- 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 according to payer and regulatory requirements
- 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
- Partner with Clinical HR, Billing, and Operations teams to resolve credentialing-related issues
- Communicate progress, risks, and timelines to managers and leadership
- Identify opportunities to improve credentialing workflows, processes, and tracking systems
Requirements
What you’ll need- 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
- 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
Benefits
Comp & perks- Paid Time Off
- Paid U.S. holidays
- Paid birthday leave