Credentialing Specialist - CalAIM - Remote

You Matter

• Make a difference every day in the lives of the underserved
• Join a mission driven organization with a people first culture
• Excellent career growth opportunities

Join us and find a career that supports:

 

• Caring for overlooked, underserved, and vulnerable patients
• Autonomy in a warm team environment
• Growth and training

 

Perks and Benefits

In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:

 

• DailyPay, receive your money as you earn it!
• Tuition Assistance and dependent Scholarships
• Employee Assistance Program (EAP) including free counseling and health coaching
• Company paid life insurance
• Tax free Health Spending Accounts (HSA)
• Wellness program featuring fitness memberships and product discounts
• Preferred banking partnership and discounted rates for home and auto loans

Why Us

Now is your moment to make a difference in the lives of the underserved.

 

If there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to “Always Do The Right Thing!”, and to collectively do our part to heal the world, one patient at a time.

 

Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. 

 

We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.

How you make a difference

 

The Credentialing Specialist manages the credentialing and enrollment process for healthcare providers, ensuring all licensure, certification, and credentialing requirements are accurately maintained and up to date. This role is responsible for reviewing provider applications, conducting primary source verification, maintaining credentialing records, and supporting provider enrollment with insurance carriers, Medicare, and Medicaid programs. The position works closely with clinical leadership, providers, and insurance organizations to ensure timely credentialing, recredentialing, and panel participation. The Credentialing Specialist also monitors compliance with credentialing standards and identifies opportunities for process improvement.

 

Key Responsibilities

 

• Manage provider credentialing, recredentialing, and enrollment processes, including application review, verification, and documentation.
• Maintain credentialing files, databases, and tracking systems to monitor license renewals, certifications, DEA registrations, and other required credentials.
• Review provider applications for completeness, investigate discrepancies, and obtain missing information as needed.
• Apply for provider participation with insurance networks, Medicare, Medicaid, and other payer panels, while monitoring application status and follow-up activities.
• Conduct credentialing audits, generate reports, recommend process improvements, and ensure confidentiality and compliance with credentialing requirements.

 

Additional Details

*** Work from Home / Remote position *** Looking for credentialing specialist that has experience with payor enrollment with MediCal or other state Medicaid programs. *** Will be needing to work 8am-5pm PST Monday thru Friday *** Compensation: $45,000/year + Comprehensive Benefits!

Qualifications & Requirements

 

Education

• High School Diploma or equivalent required.
• Some college preferred.

Experience

• Proficient in Microsoft Office.
• Strong decision-making skills.
• Ability to multitask in a fast-paced environment with a focus on time management, documentation, and communication with providers, peers, and insurance companies.

Licenses/Certifications

• None required.

 

This position is available only to those who reside in the United States.

We are an Equal Employment Opportunity Employer

We value the contributions of team members with a broad range of experiences, skills, and perspectives and are committed to providing equal employment opportunity for all.

 

We encourage you to apply! If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.

 

Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.