Enrollment & Medical License Specialist

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Summary

**This is a part time role that can potentially become full time (approximately 25 hours per week) - hours are flexible**
**This is a benefits eligible role**
**This is a remote position**

The Enrollment & Medical License Specialist is responsible for managing and facilitating credentialing, re-credentialing applications and enrollments for behavioral health providers. This role involves compiling, researching, and verifying licensing documentation, processing high volumes of payor credentialing applications, and maintaining accurate records in credentialing systems. The specialist serves as a liaison between providers, medical boards, licensing agencies and payors, ensuring timely submission and successful completion of the credentialing and re-credentialing of applications.

This role is essential for ensuring provider compliance with state and payor requirements, contributing to the efficiency and reliability of the organization’s credentialing and enrollment processes.

Description

• Investigate state-specific licensing requirements and complete necessary forms for initial and renewal applications. 
• Collect clinical and demographic data from providers as required by payors or state licensing bodies. 
• Prepare and submit applications for initial enrollment and re-enrollment in Medicaid and other plans, with appropriate follow-up. 
• Perform periodic re-credentialing to verify professional credentials and meet state licensing criteria.
• Collaborate with the Enrollment, Behavioral Health, and HR teams to manage clerical and administrative processes. 
• Maintain accurate and up-to-date documentation on credentialing platforms. 
• Support communication and coordination with delegated entities as needed. 
• Participate actively in meetings related to licensing and certification activities.

Qualifications

• A Bachelor’s degree in a related field is required, or equivalent relevant work experience is preferred. 
• Minimum of 2 years in a healthcare environment. 
• Proficiency in managing and maintaining credentialing databases; advanced experience with Microsoft Office Suite is preferred. 
• Strong oral, written, and interpersonal communication skills are required. 
• Ability to work independently while effectively collaborating with team members. 
• Ability to perform additional projects and duties as assigned. 

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

EEO Statement

PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.