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.

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