Job Application for Credentialing Specialist at Alma Back to jobs New Credentialing Specialist Remote, Contiguous US Apply Alma is on a mission to simplify access to high-quality, affordable mental health care. We do this by making it easy and financially rewarding for therapists to accept insurance and offer in-network care. When a provider joins Alma, they gain access to a suite of tools that not only help them better run their business, but also grow it sustainably and develop as a provider. Alma is available in all 50 states, with over 20,000 therapists in our growing network. Anyone looking for a therapist can browse Alma’s free directory. Alma has raised $220.5M in funding from Insight Partners, Optum Ventures, Tusk Venture Partners, Primary Venture Partners, First Round Capital, Sound Ventures, BoxGroup, Cigna Ventures, and Rainfall Ventures. Alma was also named one of Inc’s Best Workplaces in 2022 and 2023. Website Job Board Values Candidate Interview Guide --- Credentialing Specialist Position Summary We are looking for a detail-oriented Credentialing Specialist to own the end-to-end execution of our provider credentialing lifecycle. Reporting to the Credentialing Manager, you will be the engine behind our provider network’s compliance, ensuring that every clinician on our platform meets NCQA, state, and federal standards. You will manage the relationship with our Credentials Verification Organization (CVO), resolve complex enrollment bottlenecks, and ensure our data integrity remains high to prevent RCM claim denials.
What You'll Do 1. End-to-End Credentialing Execution Pipeline Management: Manage the full credentialing and re-credentialing cycle for providers across delegated and non-delegated payer arrangements. Primary Source Verification: Ensure all provider files (Licensure, DEA, Board Certs, Malpractice) are verified and maintained in accordance with NCQA standards. CAQH & System Maintenance: Serve as the internal expert on CAQH ProView; ensure provider profiles are accurate, attested, and synchronized with internal databases. CVO Partnership: Act as the primary day-to-day contact for our CVO partners, monitoring their SLAs and auditing their work for accuracy before committee review. 2. Monitoring & Compliance Maintenance Expirables Management: Proactively track and manage upcoming expirations for licenses and certifications to prevent provider "dark time" or insurance department. Ongoing Monitoring: Execute monthly checks against OIG, SAM, and Medi-Cal/Medicaid sanction lists; investigate and document any "flags" for Manager review. Committee Support: Prepare high-quality credentialing packets and summary reports for the Credentialing Committee to ensure efficient decision-making.. 3. RCM Collaboration & Process Improvement Denial Resolution: Partner with the Revenue Cycle Management (RCM) team to troubleshoot claim denials linked to credentialing or enrollment errors. Workflow Optimization: Identify repetitive manual tasks within the credentialing funnel and suggest automation or process shifts to increase "speed to lead" for new providers.
Who You Are The "Execution Expert": You have a "no stone left unturned" approach to data. You enjoy the puzzle of matching payer
requirements with provider documentation. Communication Focused: You can translate complex "credentialing-speak" into simple instructions for providers and internal stakeholders. Tech Savvy: You are comfortable navigating Credentialing Software, Zendesk, or Salesforce and can quickly learn new internal tools. Autonomous: As a Level 3, you don't need a playbook for every scenario; you can research state-specific regulations and propose a path forward.
Qualifications Experience: 4+ years of hands-on healthcare credentialing experience, including directly managing processes end-to-end (Behavioral Health experience is a major plus). Regulatory Knowledge: Solid understanding of NCQA standards and the primary source verification process. Systems: Proficiency with CAQH and experience working with a CVO. Education: Bachelor’s degree preferred, or equivalent years of specialized experience. Certification (Preferred): CPCS (Certified Provider Credentialing Specialist).
Benefits: We’re a remote-first company Health insurance plans through Aetna (medical and dental) and MetLife (vision), including FSA and HSA plans 401K plan (ADP) Lifestyle Spending Account for health, wellness, and family care Monthly co-working space membership stipend Monthly work-from-home stipend Financial wellness
benefits through Northstar Pet discount program through United Pet Care Financial
perks and rewards through PerkSpot EAP access through Aetna One-time home office stipend to set up your home office Inclusive family and medical leave plans 12 paid holidays and 1 Alma Give Back Day Flexible PTO Salary Band: $70,000 - $90,000 All Alma jobs are listed on our careers page. We do not use outside applications or automated text messaging in our recruiting process. We will not ask for any sensitive financial or identification information throughout the recruiting process. Any communication during the recruitment process, including interview requests or job offers, will come directly from a recruiting team member with a helloalma.com email address. Learn more about how Alma handles applicant data by reading Alma's Applicant Privacy Notice . Create a Job Alert Interested in building your career at Alma? Get future opportunities sent straight to your email. Create alert Apply for this job * indicates a required field Autofill with MyGreenhouse First Name * Last Name * Preferred First Name * Email * Phone Country * Phone * Resume/CV * Attach Attach Dropbox Google Drive Enter manually Enter manually Accepted file types: pdf, doc, docx, txt, rtf Cover Letter Attach Attach Dropbox Google Drive Enter manually Enter manually Accepted file types: pdf, doc, docx, txt, rtf LinkedIn Profile * To ensure compliance with Alma’s Employment of Relatives Policy, if one of your family members/relatives or someone you are living with currently works at Alma, please include their name(s) here (type N/A if not applicable): _______________. * Website Street Address Line 1 * Please provide your Legal Address . Street Address Line 2 Apt/Unit # ( if applicable) City * State * Select... ZIP Code * Please use 5 digits. Will you now, or in the future, require sponsorship for employment visa status (e.g. H-1B visa status)? * Select... Why are you interested in this role at Alma? * Diversity, Equity and Inclusion at Alma At Alma, we work hard to bring together people from a vast set of backgrounds and identities. We aspire to champion diversity, amplify inclusive cultures and build equitably. Submitting the below information is optional and your answers will not be attached to your applicant profile . All answers are compiled into an anonymous dataset and will only be seen from a macro point of view to help us inform our Diversity, Equity & Inclusion (DEI) strategy and efforts. This information will not be used as selection criteria nor will it be used as any basis in connection with any decisions regarding your candidacy. We take our DEI efforts seriously, and we would greatly appre ciate your participation. Of course, you are welcome to opt out of submitting this information and there will be no consequences for your decision not to share this information. Glossary of terms Gender is personal (how we see ourselves), while sexual orientation is interpersonal (
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Salary
$70,000 - $90,000
Location
Remote
Experience
4+ years
Total raised
$220.0M
Last stage
Growth
Investors
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