Description

We're seeking a highly motivated and entrepreneurial Enrollment Specialist to play a pivotal role in scaling our world-class clinical team during an exciting period of significant growth. You will take ownership of the complete enrollment and credentialing cycle for a diverse group of mental health professionals, including psychotherapists (LCSWs, LPCs, Psy.D, etc.), psychiatric mental health nurse practitioners (PMHNPs), and physicians. Joining our small but impactful Network Management team and reporting directly to the Provider Network Manager, you'll have a unique opportunity to shape and scale our credentialing and enrollment function while making a profound impact on women's mental healthcare.

This isn't just another enrollment specialist role – you'll be a key player in directly supporting a rapidly expanding clinical team that is revolutionizing how women access vital mental health support. You'll have the chance to actively evolve our enrollment strategies, implement innovative new processes, and have a tangible impact on the lives of thousands of women through the exceptional providers you credential and enroll.

What you’ll do

• Prepare and submit accurate and complete enrollment applications to a multitude of public and private payers across both commercial and Medicaid plans.
• Efficiently manage enrollments across multiple states and various provider types, proactively ensuring timely follow-up for all enrollments that are pending approval.
• Utilize Salesforce as our primary system for comprehensive enrollment management and meticulous tracking.
• Maintain accurate and up-to-date provider information within CAQH and all other relevant industry databases.
• Investigate and resolve enrollment discrepancies and claims disputes in close collaboration with our billing team.
• Prepare insightful reports and analyze key enrollment metrics and provider data utilizing Google Sheets and Salesforce to identify trends and areas for improvement.
• Communicate clearly and effectively with both internal teams and external payer contacts, building strong working relationships.
• Develop, document, and continuously improve efficient enrollment workflows and best practices to optimize our processes.
• Generate and submit provider rosters as required by various payers to ensure ongoing compliance.

Who you are

• You bring 3+ years of proven experience in credentialing and enrollment, specifically within the behavioral health sector.
• NAMSS (National Association of Medical Staff Services) enrollment certification is considered a significant plus!
• You have a demonstrable track record of successfully enrolling a wide range of providers with both Commercial and Medicaid plans.
• You possess exceptional attention to detail and superior organizational skills, ensuring accuracy and efficiency in all tasks.
• You have strong written and verbal communication skills, enabling you to interact professionally and effectively with various stakeholders.
• You are proficient in utilizing the Google Suite of productivity tools.
• Experience working with Salesforce or comparable CRM (Customer Relationship Management) tools is highly preferred.

Note: If you feel strongly that you have what it takes for this role but don’t check 100% of the boxes—that’s okay—we encourage you to apply anyway and highlight what you can bring to the table.