Credentialing & Compliance Specialist

$100,000 - $110,000
Full-time / Onsite

About The Role

The Credentialing & Compliance Specialist will be responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care at Mochi Health. In this role, you will be responsible for ensuring providers are credentialed, appointed, and privileged with health plans and maintain up-to-date data for each provider in credentialing databases and online systems, ensuring timely renewal of licenses and certifications. Understands managed care billing, credentialing and enrollment requirements and reimbursements methodologies and applies knowledge to identify, quantify, and address missing/incorrect charges. Assist in the development of resources for researching issues.

What You’ll Do

• Manage provider credentialing & re-credentialing, ensuring compliance with payer, state, and federal regulations.
• Identify and resolve discrepancies, following up proactively to complete credentialing and enrollment processes.
• Maintain and update credentialing databases, including CAQH, health plan directories, and internal records.
• Partner with internal teams to address provider credentialing inquiries and ensure smooth onboarding.
• Troubleshoot provider enrollment issues with payer networks, resolving credentialing and billing-related challenges.

Who You Are

• High school diploma/GED required
• 2+ years of credentialing experience within a telehealth platform, health plan, or healthcare organization.
• Deep knowledge of provider credentialing, enrollment, and regulatory requirements.
• Experience with primary source verifications, payer enrollment, and credentialing committees.
• Highly organized, detail-oriented, and proactive, with the ability to manage multiple priorities.
• Strong problem-solving skills, able to navigate credentialing complexities and recommend solutions.
• Excellent communication skills, with the ability to collaborate cross-functionally across teams.
• Proficient in Microsoft Office (Word, Excel, PowerPoint) and comfortable working with credentialing databases.

Life at Mochi

• Comprehensive Health Coverage – Medical, dental, and vision insurance to keep you at your best
• Financial Security – 401(k) with company matching and fully covered life insurance
• Time to Recharge – Unlimited PTO, generous company holidays, and flexibility to take the time you need
• Wellness First – Group activities, mindfulness sessions, and fitness perks to support your well-being
• Connection & Community – Team lunches, office hangouts, and offsite meetups to build meaningful relationships
• High-Impact Work – Shape the future of digital healthcare at a pivotal moment in our growth
• Competitive Compensation – Top-tier salary and a generous equity package
• Fast-Paced & Exciting – Join a hypergrowth team that moves fast and builds with purpose
• World-Class Team – Work alongside top engineers, product leaders, and operators in a high-performance environment
• Prime Location – Enjoy a vibrant workspace in downtown San Francisco
• In Office Perks – Unlimited espresso & matcha, breakfast and lunch, 5 days a week!

The base salary for this full-time position ranges from $100,000 to $110,000, in addition to equity and benefits. The salary range listed in each job posting represents the minimum and maximum targets for new hire salaries across all locations. Actual compensation within this range is determined by various factors, such as job-related skills, experience, relevant education or training, and location.