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Credentialing and Payer Contracting Lead (backed by Y Combinator, $5M+ ARR, $23M+ raised)

Legion Health· Operations
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Hybrid (Remote)$5/hr - $15/hrFull-timePosted 2mo ago

About the role

Credentialing and Payer Contracting Lead role at Legion Health, remote contract position focused on coordinating provider credentialing, payer enrollment, and contracting workflows across commercial and government health plans.

Responsibilities

  • Coordinate initial credentialing, payer enrollment, and recredentialing for new and existing clinicians.
  • Collect, review, and organize provider documentation, including licenses, DEA registrations where applicable, malpractice coverage, CVs, education and work history, board certifications, W-9s, NPIs, taxonomy codes, disclosures, and attestations.
  • Maintain accurate provider profiles in CAQH ProView, NPPES, PECOS, state Medicaid systems, commercial payer portals, and internal tracking systems.
  • Prepare, submit, and track enrollment applications, roster additions, demographic changes, service-location updates, reassignment requests, terminations, and payer requests for additional information.
  • Follow up consistently with payer representatives through phone, email, portals, and ticketing systems; document every interaction and escalate stalled or time-sensitive applications.
  • Support the payer-contracting lifecycle, including network-interest submissions, contracting applications, agreement intake, fee-schedule organization, redline tracking, signature routing, amendments, and renewals.
  • Route reimbursement, legal, and operational terms to the appropriate internal decision-makers for review and approval.
  • Maintain a reliable source of truth for each provider and payer, including application status, participating plans, contract status, effective dates, rates, renewal dates, outstanding items, owners, and next follow-up dates.
  • Coordinate with provider operations, revenue cycle, finance, legal, and billing teams to confirm that credentialing, contracting, roster loading, and billing setup are complete before a provider is marked ready to bill.
  • Monitor licenses, attestations, recredentialing deadlines, contract renewals, and other expirations to prevent avoidable interruptions in payer participation.
  • Investigate discrepancies across provider records, payer portals, contracts, directories, and internal systems, and drive each issue through verified resolution.
  • Track turnaround times, aging applications, upcoming deadlines, payer bottlenecks, and operational risks through clear weekly reporting.
  • Identify recurring issues and improve workflows through better templates, checklists, documentation, automation, and escalation paths.
  • Protect provider information and any patient information encountered by following Legion’s privacy, security, and access-control requirements.

Qualifications

  • 2+ years of experience in provider credentialing, payer enrollment, contract administration, provider operations, medical-staff services, revenue-cycle operations, or related healthcare administration.
  • Hands-on experience with CAQH ProView, NPPES, PECOS, Availity, state Medicaid systems, or commercial payer portals.
  • Familiarity with initial credentialing, recredentialing, roster management, provider demographic changes, and payer effective-date verification.
  • Experience supporting payer contracting, fee-schedule review, contract routing, amendments, or network-development workflows is strongly preferred.
  • Behavioral health, telehealth, or multi-state provider-network experience is a plus.
  • CPCS or another credentialing certification is a plus, but not required.
  • The most important qualifications are operational ownership, accuracy, persistent follow-through, and clear communication.

Skills

Required:Provider credentialingPayer enrollmentCAQH ProViewNPPES
Nice to have:PECOS
Last updated Sep 23, 2026. Interested? Apply on the company site.
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About Legion Health

AI-native psychiatry, built for scale and covered by insurance

Legion Health is a high-quality, AI-enabled psychiatry network where patients receive care from a provider who takes their insurance. We use LLMs and AI agents to improve care quality, streamline operations, enhance patient communications, and more.

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