Senior Credentialing & Enrollment Specialist

About us:
Forge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing the highest quality, affordable, and effective care to individuals, families, and communities in need. As the first and only behavioral healthcare provider with a proven, national payer-validated ability to drive clinical outcomes that span all areas of health, Forge Health is leading the charge in driving innovation, improving care delivery, and shaping the future of behavioral health care.

At Forge, clinical care is paramount – it’s the heartbeat of our operations and the driving force in everything we do. The skill and compassion of our staff are the crucial components to extraordinary experiences and outcomes for those we serve. With our current clinical footprint in the greater Northeast, we have offices in New York, New Jersey, Pennsylvania, New Hampshire – and we’re growing! Come join us!

Who we’re looking for:

The Senior Credentialing & Enrollment Specialist is responsible for managing the enrollment and credentialing process for all providers and facilities with government and commercial payors. This role ensures accurate and timely collection, verification, and submission of applications, tracks enrollment status, maintains provider data, and actively resolves credentialing or contracting issues to support uninterrupted billing and compliance operations.

What you’ll be doing:

• Prepare, submit, and track initial and recredentialing applications with Medicaid, Medicare, and commercial insurance payors.
• Collect and verify providers’ qualifications and documentation to ensure standards are met.
• Maintain accurate provider records including NPI, CAQH, licensure, DEA, and malpractice documentation.
• Monitor enrollment timelines and proactively follow up with payors to ensure timely approval.
• Collaborate with internal teams (billing, operations, compliance, HR) to ensure provider setup aligns with system and contractual requirements.
• Update EMR and RCM systems with credentialing and enrollment data to support billing readiness.
• Communicate enrollment status updates to leadership, regional teams, and providers.
• Research and resolve payor issues, enrollment denials, or discrepancies in provider information.
• Maintain compliance with federal, state, and payor-specific credentialing regulations.
• Support audits by providing documentation related to provider enrollment and credentialing records.
  
  

What you’ll need:

• Minimum 5-7 years of experience in healthcare payor enrollment and credentialing.
• Certified Provider Credentialing Specialist (CPCS), or similar certification, is a plus.
• Deep understanding of commercial and government payor enrollment processes and requirements.
• Proficiency in EMR/Practice Management systems and CAQH ProView.
• Excellent attention to detail, organizational skills, and follow-through.
• Strong written and verbal communication with ability to interact professionally with providers and insurance representatives.

Why Forge?

The opportunity:

Our team refuses to compromise on integrity, and we look for talented, driven hard workers who hold the same passion for the pursuit of high quality, evidence-based mental health and substance use care that we do. Our collective passion is driven and embodied by our core values:

• Fulfilling: Our work creates lives that are complete and self-actualized, enabling stronger families and communities – and a therapeutic community rewarded by success
• Optimistic: Our passionate positivity and empathy overcome setbacks and get you to your goals, scientifically and humanely
• Reciprocal: Without mutual trust and commitment, there can be no progress
• Grateful: We profoundly recognize and appreciate the trust of our patients and the commitment of our clinicians
• Evidence-Based: We are committed to measurable outcomes, which provide confidence to our patients and creates a standard of care for ourselves and others

The package:

At Forge, our people are our greatest asset. We’re collaborative, empathetic, and passionate. We learn from our mistakes, we carve out time to breathe, and we are celebrated for our wins. In short, we know that we can’t do what we do without you! So, we designed a comprehensive, competitive benefits package that reflects our appreciation of our people:

• Competitive salary aligned with your experience
• Comprehensive paid time off package
• Annual time off to volunteer
• Parental leave