Credentialing Operations Lead

Talkiatry participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For more information on E-Verify, please visit the following: EVerify Participation & IER Right to Work . At Talkiatry, we are an equal opportunity employer committed to a diverse, inclusive, and equitable workplace and candidate experience. We strive to create an environment where everyone has a sense of belonging and purpose, and where we learn from the unique experiences of those around us. We encourage all qualified candidates to apply regardless of race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status.

Talkiatry transforms psychiatry with accessible, human, and responsible care. We're a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment. 60% of adults in the U.S. with a diagnosable mental illness go untreated every year because care is inaccessible, while 45% of clinicians are out of network with insurers because reimbursement rates are low and paperwork is unduly burdensome. With innovative technology and a human-centered philosophy, we provide patients with the care they need—and allow psychiatrists to focus on why they got into medicine.

We are seeking a Credentialing Operations Lead to support the daily execution of our provider credentialing process. This role ensures we remain in full compliance with accreditation standards and payor-specific contractual requirements, adherence to SLAs and SOPs, maintains data integrity across platforms, and supports Credentialing specialists in day-to-day task execution. This is a hands-on role that includes queue management, quality checks, and direct file processing as needed during volume spikes or when specialists are unavailable. The Credentialing Operations Lead is responsible for tracking real-time file progression against SLAs, flagging delays or blockers to Credentialing leadership, coaching specialists on workflow execution, and helping reinforce quality across the credentialing lifecycle.

While this role provides technical guidance and process training to specialists, strategic leadership, cross-functional ownership, and audit oversight remain the responsibility of the Credentialing Manager.

You will:

Provide Operational Oversight & Team Supervision

Supervise Credentialing Specialists' execution of daily credentialing tasks, ensuring workflows and file progression align with defined SLAs and onboarding timelines.

Serve as a subject matter expert on credentialing workflows, helping ensure accuracy, consistency, and adherence to SOPs across the team.

Act as the first point of triage for provider delays, documentation gaps, or platform blockers, escalating issues to the Credentialing Manager with relevant context and proposed resolution paths.

Monitor the PSV inbox and Booking Calendar daily to ensure accurate scheduling and appropriate specialist coverage; troubleshoot provider mis bookings and act as backup when needed.

Maintain accurate records in internal trackers and credentialing platforms, including applying start date changes, updating license information, and triggering appropriate workflows for new start dates, and recredentialing events.

Execute the Certificate of Insurance (COI) process for new providers, additional licenses, and terminations, including internal coordination and documentation.

Process credentialing and recredentialing files as needed, particularly during volume spikes or to cover for out-of-office specialists.

Track provider onboarding progress daily using internal trackers and dashboards, and flag risks, blockers, or process deviations to Credentialing leadership in a timely and structured manner.

Quality Assurance & Process Improvement

Conduct quality review of all credentialing files to ensure alignment with documentation standards, audit readiness, and committee requirements.

Identify recurring workflow or documentation issues and escalate process gaps, training needs, or performance concerns to the Credentialing Manager.

Maintain and update operational SOPs, reference materials, and training content in collaboration with department leadership.

Provide day-to-day guidance and workflow support to Credentialing Specialists, helping troubleshoot execution issues and reinforcing adherence to SOPs and documentation standards.

Deliver workflow-based training and refreshers to Credentialing Specialists and support onboarding of new team members.

Execute monthly compliance monitoring activities, including NPDB re-enrollments, exclusion list checks (e.g., OIG, SAM), and certification audits.

Audit & Delegated Credentialing Program Support

Assist with preparing for quarterly delegated payor audits by compiling required documentation, reviewing credentialing packets to submit, and helping ensure audit readiness.

Collaborate with cross-functional partners (e.g., Compliance, HR, ClinOps, Payer Relations, Clinical) to collect and validate credentialing materials as needed by payors.

Track and maintain organized documentation logs for audit submissions, committee approvals, and supporting materials.

Assist in submitting audit materials and updating rosters and other audit-related reporting.

You have:

3+ years of experience in healthcare credentialing, with a strong understanding of end-to-end workflows.

Strong working knowledge of NCQA standards and documentation expectations.

Ability to interpret and apply accreditation standards, regulatory requirements, and internal credentialing policies.

Demonstrated ability to execute high-volume credentialing processes with precision and attention to detail.

Experience supporting peers through workflow guidance, training sessions, and quality assurance efforts ina high-volume, SLA-driven environment.

Experience with credentialing platforms (e.g., Medallion, Verifiable) and multi-state provider onboarding processes.

Excellent organizational skills and attention to detail, with the ability to manage multiple workstreams concurrently.

Strong interpersonal and communication skills, with the ability to coach peers.

Polished verbal and written communication skills, with the professionalism required to engage with clinical leaders and represent credentialing in committee settings.

Comfort operating in a fast-paced, execution-focused environment where priorities may shift frequently.

Bachelor's degree preferred.

Why Talkiatry:

Top-notch team: we're a diverse, experienced group motivated to make a difference in mental health care

Collaborative environment: be part of building something from the ground up at a fast-paced startup

Excellent benefits: medical, dental, vision, effective day 1 of employment, 401K with match, generous PTO plus paid holidays, paid parental leave, and more

Grow your career with us: hone your skills and build new ones with our Learning team as Talkiatry expands

It all comes back to care: we're a mental health company, and we put our team's well-being first