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Contracting & Credentialing Associate

Full-time

Autism Diagnosis Group

About Josi Health

Josi Health is a fast-growing remote healthcare company focused on making autism & ADHD diagnostic evaluations and therapy more accessible, faster, and less stressful for families. We operate across 40+ states and work with major insurance carriers. Our clinical network of Licensed Psychologists (PsyD/PhD) and Therapists (LCSWs, LPCs, LMHCs) must be flawlessly credentialed and enrolled across all major insurance carriers to ensure care delivery is fully reimbursable.

About the Role

We are seeking a highly organized, details-driven, and proactive Contracting & Credentialing Associate. In this role, you will own the end-to-end provider credentialing and payer enrollment lifecycle. You will act as the master coordinator ensuring our clinical team members are credentialed quickly and with zero gaps in coverage.

This is not a slow-paced data-entry job. You will run our credentialing pipeline like a high-efficiency production line – tracking strict timelines, managing provider data registries, executing primary source verifications, and proactively following up with payers to eliminate administrative delays. This role will also require strategic thinking – to identify how we can improve our internal processes, network access and optimization, network expansion opportunities and credentialing timelines.

Key Responsibilities

Provider Credentialing

  • 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

Payer Enrollment & Roster Management

  • 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

Contracting Support & Network Adequacy

  • 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

Coordination & Compliance

  • 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

What We’re Looking For

Must-Have

  • 2+ years of healthcare experience specializing in provider credentialing, payer enrollment, or provider relations
  • Highly proficient with CAQH
  • Working knowledge of medical licensing structures (e.g., PsyPact), NPI registries (NPPES), and primary source verification standards
  • Obsessive attention to detail – a missed box or expired license can disrupt operations; you double-check everything
  • Excellent written and verbal English communication skills; comfortable reaching out to busy providers and navigating complex payer customer service lines
  • Strong spreadsheet skills (Excel/Google Sheets) for tracking active pipelines and provider cohorts
  • Reliable remote work setup with backup power and high-speed internet (aligned with EST hours)

Preferred

  • Experience credentialing remote/telehealth providers across multiple states
  • Familiarity with NCQA credentialing standards, PECOS, and various state Medicaid portals
  • Experience in behavioral health networks
  • Certified Provider Credentialing Specialist (CPCS) certification

What We Offer

  • Fully remote – work from anywhere outside the US
  • Competitive monthly compensation in USD
  • Direct ownership of a vital operational pipeline in a fast-scaling startup
  • Support from a collaborative, tech-forward administrative team

How to Apply

  1. Upload your resume (PDF)
  2. Complete the short questionnaire
  3. Submit
Vacancy posted a month ago
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