About Us:
We are a growing mental health clinic committed to delivering exceptional patient care through innovative and collaborative clinical services. As we expand our partnerships across California, we are seeking a detail-oriented and experienced Medical Credentialing Specialist to join our team. This role is critical in ensuring timely and accurate onboarding of behavioral health providers with payers across the state.
Position Overview:
The Credentialing Specialist will manage and execute all aspects of the credentialing process. The ideal candidate has hands-on experience with behavioral health credentialing and is familiar with major California payers including Medi-Cal (California Medicaid), Anthem Blue Cross of California, and Kaiser Permanente. You should be confident navigating the submission, follow-up, and troubleshooting processes unique to these plans.
Key Responsibilities:
- Prepare, submit, and track credentialing and re-credentialing applications for behavioral health providers across Medi-Cal, Anthem CA, and Kaiser.
- Monitor credentialing timelines and proactively follow up with payers to avoid delays.
- Serve as the primary point of contact for credentialing-related communications with health plans and internal teams.
- Identify and escalate issues or delays as needed, and support resolution efforts to ensure timely approvals.
- Stay current with changes in payer policies and credentialing requirements specific to behavioral health.
Requirements:
- Minimum 2 years of credentialing experience in a healthcare setting.
- Direct experience credentialing providers with Medi-Cal, Anthem Blue Cross of California, and Kaiser Permanente.
- Experience credentialing behavioral health providers
- Strong understanding of payer-specific requirements, CAQH, and NPPES systems.
- Excellent attention to detail, organizational skills, and follow-through.
- Proficiency in Google Workspace (Docs, Sheets) or MS Office Suite.
- Strong communication skills and ability to work independently and collaboratively.
Compensation:
Competitive hourly rate or salary, commensurate with experience. Flexible scheduling available.
Job Types: Part-time, Contract
Pay: $22.86 - $27.00 per hour
Expected hours: 5 – 20 per week
Schedule:
Application Question(s):
- Can you walk me through a recent credentialing application you submitted to Kaiser or Anthem and what the biggest challenges were?
- Have you ever encountered an application rejection? What did you do?
- Have you ever contacted the DHCS PAVE Help Desk?
Have you ever received training on PAVE?
What steps do you take in PAVE to credential a new behavioral health provider
Work Location: Remote
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