Remote Credentialing & Enrollment Specialist II

Brightside Health; United States; Remote; USD 65,000 - 80,000; Full time

Benefits offered by this job

Comprehensive health care

Pet Insurance

Life Insurance & Disability

401k Plan

Unlimited PTO and sick leave

Remote work flexibility

Job summary

Brightside Health is seeking a Credentialing & Enrollment Specialist II to join its fully remote credentialing team as we scale nationwide. You will manage the full range of credentialing and enrollment tasks with minimal supervision, including onboarding, applications, verifications, and payer communications, while upholding NCQA standards and CAQH/PECOS processes.

This role collaborates across clinical, engineering, and product teams and offers flexible scheduling, competitive benefits, and a

Qualifications

• 3+ years of credentialing and/or enrollment operations experience.
• Experience with NCQA standards, CAQH, and payer enrollment processes.
• Experience with both commercial and government payer enrollment preferred.
• Proficiency with payer portals (CAQH, PECOS, Availity, payer-specific).
• Strong attention to detail and documentation habits, ability to manage multiple priorities.

Responsibilities

• Execute provider onboarding readiness tasks and intake packet completeness checks.
• Prepare and submit initial credentialing and re-credentialing applications.
• Submit and monitor primary source verifications through CVO.
• Perform PSV according to departmental policies and NCQA standards.
• Review CVO-processed files for completeness and accuracy.
• Process provider status changes, terminations, and reactivations.

Skills

Attention to detail

Multitasking

Experience in credentialing

Tools

CAQH

PECOS

Availity

Payer portals

NCQA standards

Job description

Brightside Health is seeking a Credentialing & Enrollment Specialist II to join its fully remote credentialing team as we scale nationwide. You will manage the full range of credentialing and enrollment tasks with minimal supervision, including onboarding, applications, verifications, and payer communications, while upholding NCQA standards and CAQH/PECOS processes.

This role collaborates across clinical, engineering, and product teams and offers flexible scheduling, competitive benefits, and a