LearnWell

Credentialing Specialist (Fully Remote)

LearnWell  •  $50k - $55k/yr  •  Rego Park, NY (Remote)  •  3 months ago
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Job Description

Job Location: Rego Park, NY 11374
Position Type: Full Time
Salary Range: $50,000.00 - $55,000.00 Salary/year
Job Shift: DayLearnWell Behavioral Health[AS1]  is a multi-state behavioral health organization supporting over 400 clinicians across New York and Massachusetts. We onboard approximately 30 new providers each month and maintain active participation across Medicare, Medicaid, and commercial insurance networks.
We are seeking a Credentialing Specialist to support our provider enrollment and credentialing operations. This position plays an essential role in ensuring clinicians are properly enrolled, maintained, and compliant across multiple payer networks.
This is an entry-level opportunity for a highly organized and detail-oriented professional who is comfortable working in a structured, process-driven environment. The ideal candidate is dependable, proactive, and able to manage high volumes of administrative detail with consistency and accuracy.
What You’ll Do
Provider Onboarding & Enrollment
- Complete and maintain CAQH and NPI profile updates for new clinicians.
- Support internal credentialing processes including:
- - License verification
- - Malpractice and liability documentation
- - Resume formatting and updates
- - Collection of required credentialing documents
- Submit credentialing and enrollment applications to Medicare, Medicaid, and commercial payers.
- Track submission timelines, follow-ups, and effective dates with precision.
- Follow up with clinicians for signatures and missing documentation to prevent delays.
Credentialing Maintenance & Tracking
- Maintain accurate provider data across Salesforce and Excel-based tracking systems.
- Monitor application status and proactively follow up with payer representatives.
- Verify participation status and effective dates.
- Process provider terminations and ensure removal from panels.
- Maintain organized documentation files for audit readiness.
Portal & Data Management
- Maintain CAQH attestations and document uploads.
- Manage payer portal accounts and login access.
- Conduct roster audits and reconcile discrepancies with payer directories.
- Ensure internal and external records align accurately.
Who You Are
You’re someone who:
- Finds satisfaction in clean data and organized systems.
- Enjoys process-driven work and takes pride in getting details right.
- Follows up persistently until something is fully resolved.
- Can manage multiple moving pieces without losing track.
- Works independently and stays productive in a remote environment.
- Wants to grow within healthcare operations.

Qualifications
- Bachelor’s degree or equivalent relevant experience.
- Strong organizational and time management skills.
- Excellent written communication and professional follow-up skills.
- Comfortable navigating multiple online portals simultaneously.
- Proficiency in Microsoft Excel.
- Familiarity with healthcare terminology (CAQH, NPI, PECOS, Medicare, Medicaid) preferred but not required.
- Ability to work independently in a fully remote environment.
LearnWell

About LearnWell

LearnWell is specialized and dedicated to supporting the 49% of all students who may face an underlying mental health condition—such as depression, anxiety or other mood disorders—which often manifest in self-destructive behavior, substance use, and eating disorders. In partnership with treatment facilities and school districts, we provide an integrated set of academic and mental wellness services for students and their families throughout the continuum of care. As students begin to show signs of emerging mental health needs, our psychiatric counseling teams provide therapeutic support for schools to help reduce the risk of hospitalization or other crises. When students are hospitalized, our educators provide a specialized approach to supporting the academic progress for those receiving mental health treatment. Upon discharge from the hospital, we provide the ongoing mental health counseling and one-to-one academic tutoring for students as they re-integrate back into the classroom environment.

Industry
Healthcare & Social Services
Company Size
201-500 employees
Headquarters
Plymouth, Massachusetts
Year Founded
1995
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