Credentialing Lead – Delegated Payer Audits

Behavioral Health Tech, Inc.; New York (NY); Remote; USD 62,000 - 64,000; Full time

Job summary

An established industry player is looking for a Credentialing Lead to enhance their delegated credentialing program. This pivotal role involves supporting payor audits, ensuring compliance with accreditation standards, and collaborating with various teams to prepare audit-ready materials. You will leverage your expertise in healthcare credentialing and NCQA standards to maintain high-quality documentation and support process improvements. If you are detail-oriented and passionate about making a difference in mental health care, this opportunity offers a collaborative environment with excellent benefits and career growth potential.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401K with Match

Generous PTO

Paid Holidays

Paid Parental Leave

Flexible Work Location

Career Development Opportunities

Qualifications

• 3+ years of experience in healthcare credentialing with delegated credentialing exposure.
• Strong knowledge of NCQA standards and payor obligations.

Responsibilities

• Assist with quarterly delegated payor audits and maintain documentation.
• Conduct quality reviews of credentialing files for compliance.

Skills

Healthcare Credentialing

Delegated Credentialing

Payor Audit Preparation

NCQA Standards Knowledge

Attention to Detail

Organizational Skills

Communication Skills

Cross-functional Collaboration

Education

Bachelor's Degree

Tools

Medallion

Verifiable

Job description

We are seeking a Credentialing Lead – Delegated Payor Audits to strengthen our delegated credentialing program and ensure we remain in full compliance with accreditation standards and payor-specific contractual requirements. This role plays a key part in supporting quarterly payor audits, reinforcing quality across the credentialing lifecycle, and maintaining the documentation that demonstrates our adherence to delegation agreements — including internal policies, procedures, and credentialing file evidence.

You’ll work closely with the Credentialing Manager and collaborate cross-functionally with Compliance, ClinOps, Clinical Leadership, Payer Relations, and HR to prepare, track, and submit audit-ready materials. While this is not a people management role, it serves as a subject matter expert on delegated credentialing and provides backup QA support to the Credentialing Operations Lead when needed.

About Talkiatry:

Talkiatry transforms psychiatry with accessible, human, and responsible care. We’re a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment.

60% of adults in the U.S. with a diagnosable mental illness go untreated every year because care is inaccessible, while 45% of clinicians are out of network with insurers because reimbursement rates are low and paperwork is unduly burdensome. With innovative technology and a human-centered philosophy, we provide patients with the care they need—and allow psychiatrists to focus on why they got into medicine.

You will:

• Audit & Delegated Credentialing Program Support
• Assist with preparing for quarterly delegated payor audits by compiling required documentation, reviewing credentialing packets to submit, and helping ensure audit readiness.
• Collaborate with cross-functional partners (e.g., Compliance, HR, ClinOps, Payer Relations, Clinical) to collect and validate credentialing materials as needed by payors.
• Track and maintain organized documentation logs for audit submissions, committee approvals, and supporting materials.
• Assist in submitting audit materials and updating rosters and other audit-related reporting.

• Credentialing QA & File Review
• Conduct targeted quality reviews of completed credentialing files to verify alignment with delegated payor requirements and NCQA standards, particularly in preparation for audits.
• Serve as a backup QA reviewer when the Credentialing Operations Lead is out of office or during periods of high volume.
• Provide feedback to the Credentialing Manager on trends in QA issues and recommend process or training updates.

• Policy, Documentation & Process Alignment
• Support development and refinement of internal credentialing SOPs and reference materials, ensuring alignment with delegated contract obligations and regulatory changes.
• Help maintain documentation control and support tracking of changes to credentialing standards, forms, and workflows.
• Participate in internal meetings to align with other Leads on quality and process expectations.

• Other Responsibilities
• Join payor audit calls as needed, representing credentialing documentation efforts and assisting with follow-up tasks.
• Contribute to department training materials and process improvement initiatives.
• Provide back-up operational support as needed, including assisting with provider files or PSV workflows in high-volume periods.

You have:

• 3+ years of experience in healthcare credentialing, with specific exposure to delegated credentialing and/or payor audit preparation.
• Strong working knowledge of NCQA standards, CMS requirements, and delegated payor obligations.
• Proven experience preparing for payor audits or maintaining documentation required under delegation agreements.
• Ability to interpret and apply accreditation standards, regulatory requirements, and internal credentialing policies.
• Skilled in creating and maintaining SOPs, policies, and audit documentation repositories.
• Exceptional attention to detail and organizational skills, particularly in managing complex documentation workflows.
• Polished verbal and written communication skills, with the professionalism and discretion required to represent the organization in payor audits and compliance discussions.
• Comfortable working cross-functionally with compliance, clinical, and operational teams to gather and align documentation.
• Experience with credentialing platforms (e.g., Medallion, Verifiable) preferred.
• Bachelor’s degree preferred.

Why Talkiatry:

• Top-notch team: we're a diverse, experienced group motivated to make a difference in mental health care
• Collaborative environment: be part of building something from the ground up at a fast-paced startup
• Flexible location: work where you want to, either remotely across the U.S. or from our HQ in NYC
• Excellent benefits: medical, dental, vision, effective day 1 of employment, 401K with match, generous PTO plus paid holidays, paid parental leave, and more!
• Grow your career with us: hone your skills and build new ones with our Learning team as Talkiatry expands
• It all comes back to care: we’re a mental health company, and we put our team’s well-being first

$62,000 - $64,000 a year

Compensation range for this position is $62,000 to $64,000, depending on experience; actual compensation will be dependent upon the specific role, location, as well as the individual’s qualifications, experience, skills and certifications.