Remote Credentialing & Enrollment Specialist II

brightside-health-jobs; United States; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Dental & vision

401k plan

Unlimited PTO

Parental Leave

Remote work

Career development

Job summary

Brightside Health is a fully remote company delivering innovative virtual mental healthcare. We seek a Credentialing & Enrollment Specialist II to join our national operations and manage the provider lifecycle from onboarding to renewals.

You will execute credentialing and enrollment tasks, ensure accuracy, and collaborate with cross-functional teams while upholding NCQA standards and payer requirements.

Qualifications

• 3+ years of credentialing/enrollment experience.
• Familiarity with NCQA standards and payer enrollment processes.
• Experience with commercial and government payers.

Responsibilities

• Execute onboarding readiness tasks and intake packet checks.
• Submit initial credentialing and re-credentialing applications.
• Submit and monitor primary source verifications through CVO.
• Review CVO-processed files for completeness and accuracy.
• Track enrollment statuses and update Salesforce accordingly.
• Maintain payer portal accounts and manage CAQH/PECOS profiles.

Skills

Attention to detail

Time management

Ability to manage multiple priorities

Tools

CAQH

PECOS

Availity

Payer portals

Job description

Brightside Health is a fully remote company delivering innovative virtual mental healthcare. We seek a Credentialing & Enrollment Specialist II to join our national operations and manage the provider lifecycle from onboarding to renewals.

You will execute credentialing and enrollment tasks, ensure accuracy, and collaborate with cross-functional teams while upholding NCQA standards and payer requirements.