Provider Enrollment and Credentialing Specialist

About GetPaneled

GetPaneled helps healthcare providers, primarily behavioral health professionals and group practices, get credentialed and enrolled with insurance payers across the United States.

We are a growing U.S.-based company building technology to make provider credentialing faster, more reliable, and easier to manage.

We are looking for an experienced credentialing specialist who can independently manage provider enrollment work and help us deliver a high-quality experience for our customers.

This is not a general virtual assistant role. We are specifically looking for someone with hands-on experience in U.S. healthcare credentialing, payer enrollment, or provider enrollment.

What You Will Do

You will manage credentialing and enrollment work for individual providers and group practices, including:

Commercial payer enrollment and credentialing
Medicare enrollment through PECOS
Medicaid enrollment through state-specific portals
CAQH setup, maintenance, and reattestation
NPI and NPPES review and updates
Individual and group provider applications
Adding rendering providers to existing groups
Reviewing W-9, Tax ID, NPI, practice, and provider information for consistency
Uploading required documents and completing payer forms
Following up with insurance companies by portal, email, or phone
Tracking application status and next follow-up dates
Reviewing payer correspondence and determining next steps
Identifying and resolving application issues
Requesting missing information from providers
Updating internal application records accurately
Responding to routine provider and customer questions by email
Escalating unusual or high-risk situations when appropriate
What We Are Looking For

You should have at least 2 years of direct U.S. provider credentialing or payer enrollment experience.

Strong candidates will have experience with several of the following:

Aetna
UnitedHealthcare and Optum
Cigna and Evernorth
Blue Cross Blue Shield plans
Humana
Carelon
Molina
Ambetter and Centene
Medicare and PECOS
State Medicaid programs
CAQH ProView
NPPES
Availity

Behavioral health credentialing experience is strongly preferred, including experience with providers such as:

LCSW
LMFT
LPC
LMHC
Psychologists
Psychiatrists
PMHNPs
Nurse Practitioners

Experience with both individual and group practice enrollment is a major plus.

The Most Important Qualities

We care more about judgment and ownership than simply knowing how to fill out forms.

You should be someone who:

Can work independently without needing constant instructions
Notices inconsistencies before submitting an application
Can investigate an unfamiliar payer issue and determine the next step
Knows when something is routine and when it should be escalated
Follows through until an issue is actually resolved
Is highly organized and does not allow applications or follow-ups to fall through the cracks
Communicates clearly in written English
Is comfortable communicating professionally with U.S. healthcare providers and insurance companies
Takes responsibility for mistakes and learns from them
Is comfortable working in a fast-moving startup environment where processes are continuously improving

Schedule
Full-time
40 hours per week
Long-term position
Overlap with U.S. Eastern Time will be required
Exact working hours can be discussed
Compensation

$7 to $12 USD per hour depending on experience and demonstrated ability.

Candidates with stronger credentialing experience, strong independent judgment, or the ability to handle more complex cases may qualify for the higher end of the range.

There may also be opportunities for increased responsibility and compensation over time based on performance.

Growth Opportunity

We are building a growing credentialing operation alongside automation and AI systems.

Strong performers may have opportunities to take on responsibilities such as:

Quality assurance
Training other team members
Reviewing difficult applications
Managing payer workflows
Helping improve credentialing procedures
Supporting and evaluating automation systems

We are looking for people who are interested in growing with the company and taking increasing ownership over time.

How to Apply

Please answer the following questions in your application.

How many years of direct U.S. healthcare credentialing or payer enrollment experience do you have?
Which insurance payers have you personally completed applications for? Please separate commercial insurance, Medicare, and Medicaid.
Which Medicaid states have you personally enrolled providers in?
Describe your Medicare and PECOS experience. Please explain what types of applications you have personally completed.
Have you credentialed both individual providers and group practices? Please explain.
Approximately how many provider or payer applications have you managed at one time?
Tell us about one difficult credentialing problem you personally solved. Please explain:
What went wrong?
How did you identify the problem?
What did you do?
What was the outcome?
Imagine an application has been sitting with a payer for 45 days and the provider asks for an update. What steps would you take before responding to the provider?
If information in CAQH does not match the provider's W-9 or NPI record, what would you do before submitting the payer application?
What hourly rate are you requesting in USD?
Are you available for 40 hours per week?
Please include the phrase "Provider Enrollment" at the top of your application so we know you read the full posting.