Remote Credentialing & Licensing Specialist

Betterhealth-A-Planned-Parenthood-Partnership; United States; Remote; USD 36,000 - 39,000; Full time

Job summary

BetterHealth seeks a Credentialing and Licensing Specialist to verify licensure and credentials for providers, manage CAQH Proview and ARMS processes, and support payer enrollment activities. The role emphasizes accuracy, timeliness, and strong communication with internal teams and affiliate clients.

The specialist will maintain electronic credentialing records, work with third‑party systems, and ensure compliance across Medicaid, Medicare, and commercial payers while handling sensitive

Qualifications

• High school diploma or GED.
• Minimum three years direct experience with credentialing providers in a medical practice, knowledge of credentialing process with health insurance plans and CAQH Proview.

Responsibilities

• Performs all credentialing and licensing duties with superior expertise, consistency, and quality.
• Demonstrates effective customer service and communication skills to enhance relations with internal team members and affiliate client relations.
• Displays professionalism and encourages a positive, team-oriented work environment.
• Demonstrates ability to be a self-starter and work with minimal direction.
• Compile and maintain current and accurate electronic data for all providers.
• Complete and maintain ARMS credentialing and recredentialing for organizations using BetterHealth services.
• Maintain documentation within third-party software systems (Modio, CredentialSmart) for primary source verification.
• Create, update, and maintain CAQH Proview accounts for physicians and QHPs.
• Acquire accounts for new providers not previously registered with CAQH.
• Obtain, update, and maintain NPPES/PECOS accounts for APRNs, PAs and physicians.
• Maintain electronic copies of licenses, board certifications, DEA registration, and other credentialing documents.
• Obtain electronic signatures for new providers as needed.
• Complete, monitor and follow-up provider credentialing with payers including Medicaid/Medicare.
• Provide demographic updates to payers when providers are added or terminated.
• Maintain electronic folders of signed contracts.

Skills

Credentialing

Licensing

CAQH Proview

NPPES

PECOS

Provider enrollment

Data entry

Compliance

Medicaid

Communication

Attention to detail

Education

High school diploma

GED

Tools

Modio

CredentialSmart

Job description

BetterHealth seeks a Credentialing and Licensing Specialist to verify licensure and credentials for providers, manage CAQH Proview and ARMS processes, and support payer enrollment activities. The role emphasizes accuracy, timeliness, and strong communication with internal teams and affiliate clients.

The specialist will maintain electronic credentialing records, work with third‑party systems, and ensure compliance across Medicaid, Medicare, and commercial payers while handling sensitive