Remote Contracting and Credentialing Specialist for Mental Health Care Company

## About the Role As a Contracting and Credentialing Specialist at Pearl Talent, you will play a critical role in ensuring the smooth operation of provider credentialing and payer contracting for a US-based healthcare provider organization. Your expertise will be leveraged to manage the full lifecycle of provider credentialing, from preparation and submission of applications to tracking and maintaining credentialing files. You will work closely with the team to resolve enrollment and contracting discrepancies, ensuring that providers remain fully credentialed and payer contracts are up-to-date and compliant.

The organization operates within the Applied Behavior Analysis and behavioral health sector, coordinating across multiple insurance payers and provider networks. The team prioritizes clean documentation, compliance, and operational reliability, and is committed to training the right hire on its internal systems and processes.

In this role, you will have the opportunity to work remotely from the Dominican Republic or Honduras, with a schedule that aligns with Central Standard Time (CST). You will be part of a team that values attention to detail, organization, and the ability to work independently.

## What You Will Do - Maintain and update credentialing files, ensuring accuracy and compliance with regulatory requirements - Prepare, submit, and track credentialing and re-credentialing applications with insurance payers and networks - Review and negotiate payer contracts, managing contract renewals and amendments - Resolve enrollment and contracting discrepancies, collaborating with internal stakeholders and external payers - Develop and implement process improvements to enhance credentialing and contracting workflows - Provide limited support to billing tasks, ensuring seamless revenue cycle operations - Stay up-to-date with changing regulatory requirements, insurance payer policies, and industry best practices - Collaborate with the team to ensure 100% CRM hygiene and on-time reporting - Participate in training and development opportunities to enhance skills and knowledge

## What We Are Looking For - 2+ years of experience in healthcare contracting, credentialing, or revenue cycle management - Hands-on experience preparing, submitting, and tracking credentialing and re-credentialing applications - Working knowledge of insurance verification, payer enrollment, and provider data management - Experience reviewing, negotiating, and managing payer contracts - Proficiency with credentialing software platforms and Microsoft Office, particularly Excel - Familiarity with both payer-side and provider-side healthcare operations - C1+ English language proficiency for effective communication with payers and stakeholders - Strong attention to detail, organizational skills, and ability to work independently

## Nice to Have - Experience in Applied Behavior Analysis (ABA) or behavioral health settings - Working knowledge of CAQH, NPI registry, and insurance payer portals - Exposure to medical billing or claims follow-up within a revenue cycle team - Track record of process improvement in credentialing or contracting workflows

## Benefits and Perks - Competitive salary based on experience and skills - Fully remote work arrangement, allowing you to work from anywhere in the Dominican Republic or Honduras - Team incentives for maintaining 100% CRM hygiene and on-time reporting - Generous PTO policy, in accordance with company standards - Health coverage for full-time employees, including HMO coverage after 3 months - Direct mentorship from international industry experts - Ongoing access to resources for professional growth and development - Global networking opportunities, connecting you with professionals worldwide

- Ensure your Excel skills are up-to-date, as proficiency in this tool is essential for the role.

• Develop a strong understanding of insurance verification, payer enrollment, and provider data management to stand out as a candidate.
• Be prepared to provide specific examples of your experience with credentialing software platforms and payer contracts during the interview process.
• Highlight any process improvements you have implemented in previous roles to demonstrate your ability to enhance workflows.
• Consider obtaining certifications in healthcare contracting or credentialing to enhance your career prospects and demonstrate your commitment to the field.
• When negotiating salary, be prepared to discuss your experience, skills, and industry standards to ensure a competitive offer.
• Pay attention to the company culture and values during the interview process, as a strong fit is crucial for success in a remote work environment.