Licensing and Credentialing Specialist

Responsibilities

• Own the end-to-end payer enrollment process for new and existing providers across commercial, Medicare, and Medicaid health plans
• Submit, track, and proactively follow up on payer enrollment applications to minimize delays to patient care and revenue
• Serve as the primary point of contact with health plans, delegated credentialing organizations, and CVOs
• Maintain accurate provider data across payer portals, CAQH, and internal tracking tools
• Support delegated credentialing activities, including roster maintenance and audit preparation
• Conduct routine audits of provider enrollment and credentialing files to ensure compliance with NCQA, CMS, and state requirements
• Monitor provider licenses, DEA/CDS registrations, board certifications, and malpractice coverage
• Collaborate with Practice Operations, Revenue Cycle, and Clinical Operations teams to ensure provider readiness

Requirements

• Bachelor’s Degree in Healthcare administration or related field
• 3+ years of experience in provider payer enrollment and credentialing
• Experience managing enrollments with commercial, Medicare, and Medicaid payers
• Experience supporting delegated credentialing activities and audit preparation
• Experience with multi-state or national provider organizations
• Working knowledge of CAQH, payer portals, and provider credentialing systems
• Understanding of NCQA, CMS, and state licensing requirements
• Proficiency with Google Workspace and Google Sheets

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) certification
• 1+ year working in Verifiable Enrollment and Licensing Manager
• Experience in a virtual care or telehealth environment
• Experience in a fast-paced, high-growth startup environment
• Experience working with credentialing vendors (CVOs)

Benefits

• Salary range of $65,000-$75,000 per year plus bonus eligibility
• Employer-sponsored medical, dental, and vision coverage
• Unlimited PTO and 11 paid company holidays
• 401(k) contribution eligibility
• Remote-first work environment

About the Company

Oshi Health is a virtual digestive health practice on a mission to transform GI care through a digital clinic model that provides integrated, multidisciplinary care.