Single TIN Credentialing Analyst

About AMM

AMM (Advanced Medical Management) is a Long Beach, California-based management services organization (MSO) supporting Seoul Medical Group's multi-state independent physician network and its affiliated employed-provider (single-TIN) medical groups. AMM provides credentialing, licensing, provider data, payer contracting, and operational support for physicians across California, Washington, Hawaii, New York, New Jersey, and Georgia.

About the Role

We're looking for a detail-driven Single TIN Credentialing Analyst to own end-to-end credentialing, enrollment, and licensing for the physicians and advanced practice providers employed by our single-TIN medical groups. Many of these providers are transitioning from hospital employment to group practice and rely on this role to navigate credentialing, state licensing, and enrollment prerequisites for the first time. You'll perform NCQA-compliant credentialing and file assembly, manage multi-state license and DEA applications, and keep providers on track from offer acceptance through committee approval, payer enrollment readiness, submission, and directory listing.

Key Responsibilities

Provider Credentialing

• Perform initial credentialing and recredentialing in accordance with NCQA standards, health plan requirements, and company policies.
• Conduct primary source verification (PSV) of licensure, DEA, board certification, education and training, work history, malpractice history, and sanctions/exclusions (NPDB, OIG/SAM, Medicare Opt-Out, state Medicaid).
• Assemble complete provider profile intake documentation and enrollment applications for payor submission; provide one-on-one provider support sessions as needed.
• Prepare audit-ready credentialing files for Credentialing Committee review; track each file through approval, submission, and directory listing.
• Collect and verify malpractice insurance certificates (COI) and tail coverage documentation; manage expirable documents such as licenses, DEA registrations, board certifications, and COIs with proactive renewal outreach.
• Coordinate CAQH profile setup, maintenance, and attestations.
• Maintain separation-of-duties and conflict-of-interest safeguards consistent with NCQA credentialing standards.

Provider Licensing & Certifications

• Prepare, submit, and track state medical license applications and renewals as providers join or expand into new markets (CA, WA, HI, NY, NJ, GA, plus).
• Manage DEA and state controlled-substance registrations, including fingerprinting and licensing-board correspondence through approval.
• Guide newly employed physicians through licensing and credentialing prerequisites with clear checklists and support sessions.

Payer Enrollment & Roster Management

• Work to ensure timely processing of provider credentialing and payer enrollment.
• Reconcile payer rosters against internal provider data management resources and employment/sub-contractor status to ensure enrollments, changes/updates, and terminations are processed accurately and timely by payers.
• Perform quarterly Operations Reconciliation of provider rosters, enrollment status, and directory listings.

Coordination, Tracking & Compliance

• Maintain the provider onboarding and credentialing status tracker; report status, aging, and blockers to leadership.
• Review intake packets for completeness (practice locations, TINs, licensure, malpractice/COI) before submission.
• Track and report all data and updates in applicable software/databases.
• Support delegated credentialing audits and health plan or regulatory audit preparation with organized, retrievable documentation.
• Assist as needed with payer and provider inquiries; perform other duties and special projects required by the department.

Qualifications

• 3+ years of provider credentialing experience with a medical group, IPA, MSO, CVO, or health plan.
• Working knowledge of NCQA credentialing standards and primary source verification requirements.
• Hands-on experience with state medical board licensing and DEA registration processes.
• Proficiency with CAQH ProView, NPPES, PECOS, and credentialing databases/software; strong Microsoft 365 and Excel skills.
• Proven ability to independently manage a high-volume pipeline with accuracy and follow-through in a remote setting.
• High school diploma or equivalent.

Preferred Qualifications

• CPCS or CPMSM certification (NAMSS).
• Multi-state licensing experience; Washington, Hawaii, New York, New Jersey, or Georgia a plus.
• Experience in a delegated credentialing environment and supporting physicians transitioning from hospital employment to group practice.
• Associate or bachelor's degree.
• Bilingual (Korean or Spanish) a plus.

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!