Remote Credentialing & Licensing Specialist (Multi-State)

Advanced Medical Management, Inc.; Long Beach (CA); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health coverage

HMO and flexible PPO plan

Vision & dental premiums

PTO and sick pay

13 paid holidays

Tuition reimbursement

Job summary

Advanced Medical Management, Inc. is looking for a Provider Credentialing & Licensing Specialist to own end-to-end credentialing and licensing for physicians and APPs across our medical groups.

You will perform NCQA-compliant PSV, manage multi-state license/DEA apps, and guide providers from offer through committee approval and payer enrollment readiness. Responsibilities include assembling audit-ready files, tracking statuses, and coordinating with onboarding, engagement, and regulatory teams.

Qualifications

• Perform initial credentialing and re-credentialing for employed providers in NCQA-compliant fashion.
• Conduct PSV of licensure, DEA, board cert, education, work history, malpractice, sanctions/exclusions.
• Assemble audit-ready files for Credentialing Committee review; track through approval and enrollment readiness.
• Collect and verify COIs and tail coverage; ensure timely file completion.
• Manage expirable licenses, DEA regs, and board cert renewals with proactive outreach.
• Maintain separation-of-duties and conflict-of-interest safeguards per NCQA standards.

Responsibilities

• Credentialing for employed providers including PSV per NCQA and plan requirements.
• License and DEA applications; manage multi-state processes.
• Coordinate onboarding through committee review and payer enrollment readiness.
• Maintain and verify COI, tail coverage, and renewals; ensure file completeness.
• Collaborate with Enrollment, Provider Engagement, HR and leadership across states.

Skills

Credentialing experience

NCQA standards

Primary source verification

State licensing knowledge

CAQH ProView

MS Excel & 365

Remote/hybrid work

Education

High school diploma or equivalent

Associate or bachelor's degree

Tools

CAQH ProView

NPPES

PECOS

Credentialing databases/software

Job description

Advanced Medical Management, Inc. is looking for a Provider Credentialing & Licensing Specialist to own end-to-end credentialing and licensing for physicians and APPs across our medical groups.

You will perform NCQA-compliant PSV, manage multi-state license/DEA apps, and guide providers from offer through committee approval and payer enrollment readiness. Responsibilities include assembling audit-ready files, tracking statuses, and coordinating with onboarding, engagement, and regulatory teams.