Insurance Credentialing Specialist Needed for Mental Health Private Practice (CA, WA, IA & VT)
Job Overview: I am a Licensed Clinical Social Worker (LCSW) with a growing telehealth/private practice seeking an experienced insurance credentialing specialist to assist with commercial PPO credentialing and provider enrollment in multiple states. I am currently licensed in:
- California
- Washington State
- Iowa
- Vermont
- Texas
- Florida
My practice provides:
- Individual psychotherapy (telehealth and in-person)
- Immigration psychological evaluations (VAWA, Asylum, Hardship Waivers)
I am looking for someone with direct experience credentialing behavioral health providers with commercial insurance plans.
- *Primary Responsibilities:**
• Complete and submit insurance credentialing applications
- Assist with CAQH profile setup and maintenance (I already have a profile)
- Submit and track provider enrollment applications
- Communicate with insurance companies regarding application status
- Help obtain contracts and fee schedules
- Ensure all supporting documents are accurate and complete
- Maintain organized tracking of all credentialing progress
- *Priority Insurance Panels Include:**
• *California** • Blue Shield of California PPO
- Anthem Blue Cross
- Aetna
- Optum / UnitedHealthcare
- Cigna
- *Washington State**
• Premera Blue Cross
- Regence BlueShield
- Aetna
- Optum / UnitedHealthcare
- Commercial PPO plans
- *Iowa**
• Wellmark Blue Cross Blue Shield
- Aetna
- Optum / UnitedHealthcare
- Cigna
- Medica
- *Vermont**
• Blue Cross Blue Shield of Vermont
- MVP Health Care
- Aetna
- Optum / UnitedHealthcare
- Cigna
- *Preferred Qualifications:**
• Previous credentialing experience with therapists, psychologists, psychiatrists, or behavioral health practices
- Familiarity with:
- CAQH
- PECOS
- NPPES
- Availity
- Provider enrollment portals
- Experience with telehealth provider enrollment
- Strong communication and organizational skills
- Ability to work independently and provide regular updates
- *Please Include in Your Proposal:**
• Your credentialing experience
- Insurance panels you have worked with
- Estimated turnaround times
- Your pricing structure
- Any references or examples of previous work
This may become an ongoing position as the practice continues to expand into additional states and insurance networks. Apply tot his job Apply To this Job