job description
Join BruntWork as a Remote Credentialing Specialist and play a pivotal role in supporting a leading US-based behavioral healthcare organization. This is a unique opportunity to work from the stunning locations of Bali while ensuring seamless provider enrollment, credentialing, and compliance processes for mental health professionals.
In this role, you will act as the bridge between healthcare providers and insurance payors, ensuring accurate and timely credentialing to maintain compliance with industry regulations. Your expertise will directly impact the organization’s ability to deliver critical behavioral health services to patients in need.
If you have a keen eye for detail, strong organizational skills, and a passion for healthcare administration, this fully remote position offers the perfect blend of professional growth and work-life balance in a tropical paradise.
Responsibility
- Manage end-to-end provider credentialing processes, including application submissions, follow-ups, and verification with insurance payors.
- Ensure compliance with NCQA, CMS, and state-specific regulatory requirements for behavioral health providers.
- Maintain accurate and up-to-date records in credentialing databases and provider management systems.
- Coordinate with healthcare providers to gather and verify required documentation (e.g., licenses, malpractice insurance, DEA certificates).
- Liaise with insurance companies to resolve credentialing discrepancies and expedite approvals.
- Monitor and track credentialing deadlines to prevent lapses in provider network participation.
- Generate reports on credentialing status, re-credentialing cycles, and compliance metrics for stakeholders.
- Stay current with changes in behavioral health credentialing standards and payor requirements.
Qualifications
- Minimum 2+ years of experience in provider credentialing, preferably in behavioral health or mental health services.
- In-depth knowledge of CAQH ProView, NPPES, and other credentialing platforms.
- Familiarity with US healthcare payors (e.g., Medicare, Medicaid, commercial insurers) and their credentialing processes.
- Strong attention to detail and ability to manage high volumes of documentation with accuracy.
- Excellent written and verbal communication skills in English (required for US client interactions).
- Proficiency in Microsoft Office Suite (Excel, Word) and credentialing software.
- Ability to work independently in a remote setting with reliable internet connectivity.
- Certification such as CPMSM (Certified Provider Credentialing Specialist) is a plus.