Credentialing & Enrollment Coordinator

The Jewish Board • New York, NY

6d • Remote

About The Position

The Credentialing & Enrollment Coordinator manages end-to-end credentialing, re-credentialing, and payer enrollment for The Jewish Board’s medical and behavioral health providers. This remote role is based in Mexico, Peru, or Colombia and supports compliance with federal and New York State payer regulations, with particular attention to PECOS, OPRA, and state mental hygiene frameworks. The Coordinator works with digital platforms, databases, and A.I. tools to track requirements, interpret regulatory changes, and streamline workflows. The role collaborates with New York-based Human Resources, Recruitment, and Program Directors to onboard employees, obtain required credentials, and protect billing relationships across the agency’s clinic locations.

The position involves managing enrollment and credentialing across federal, state, and commercial payers; maintaining New York-specific enrollment workflows; and verifying credentials for a range of medical and behavioral health professionals. It also includes data visualization and reporting, use of Tableau and generative A.I. tools, investigation of enrollment-related claim rejections, and primary source verification in line with applicable guidelines. Other projects may be assigned by the Senior Director.

Requirements

• Minimum 3–5 years of healthcare credentialing and provider enrollment experience.
• Documented exposure to U.S. healthcare insurance, behavioral health, mental health clinics, or social services structures.
• C1/C2 professional-level written and spoken English.
• Mastery of PECOS, NPPES, and CAQH ProView.
• Familiarity with New York State Medicaid, eMedNY, OMH, and OASAS provider enrollment registry workflows.
• Deep understanding of U.S. healthcare compliance, NCQA standards, and government billing regulations.
• Documented comfort using Tableau for reporting and flexibility with generative A.I. platforms.
• Ability to maintain focus while reviewing high volumes of digital data, regulatory documents, and complex spreadsheets.
• Ability to multitask across multiple software platforms and A.I. tools in a remote setting.
• Reliable, high-speed, secure internet connection capable of supporting databases, video conferencing, and A.I. tools.
• Ability to perform prolonged periods of sitting or standing at a desk and working on a computer.

Nice To Haves

• Bachelor’s degree in Healthcare Administration, Human Services, Business, or a related field; equivalent direct experience is fully considered.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) designation.

Responsibilities

• Coordinate initial enrollment, revalidation, and ongoing maintenance across federal, state, and commercial payers, including PECOS and OPRA compliance.
• Maintain knowledge of New York regulatory bodies and manage enrollment workflows through eMedNY, OMH, and OASAS portals.
• Manage credentialing portfolios for behavioral health and medical staff, including LCSWs, LMHCs, MDs, PAs, and NPPs, in alignment with NYSED licensing parameters.
• Partner with HR, Talent Acquisition, and Clinical Operations to obtain pre-employment documentation and accelerate credentialing verification for new employees.
• Maintain complex databases and use Tableau to create, update, and present dashboards on credentialing pipelines, expiration timelines, and application aging.
• Use generative A.I. tools, specifically Claude and Microsoft Copilot, to summarize regulatory changes, draft compliance correspondence, and automate administrative tasks.
• Investigate and audit provider enrollment-related claim rejections with the billing team, and correct data in clearinghouses or state payer registries to reduce revenue leakage.
• Perform primary source verification of state licenses, DEA certificates, malpractice coverage, and education history in accordance with NCQA, New York State Department of Health, and state oversight board guidelines.
• Complete other projects assigned by the Senior Director.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed