Credentialing and Enrollment Specialist

Youth and Family Alternatives • New Port Richey, FL

3d • Onsite

About The Position

This is a part-time administrative position responsible for provider payer credentialing and network enrollment. The role requires a commitment to incorporating principles of trauma-informed care in all areas of service delivery, demonstrated through active participation in agency-required training, use of trauma-informed practices, and understanding that trauma-informed environments require cultural sensitivity and an emphasis on a safe and respectful environment for all.

Requirements

• High School Diploma or equivalent required.
• Credentialing Specialist Certification required.
• 2 years of experience with Medicaid and commercial insurance network payer enrollment, provider credentialing, and billing required.
• Ability to communicate effectively, verbally, and in writing.
• Ability to document timely in a clear, concise, accurate, and detailed manner.
• Ability to audit and verify accurate documentation.
• Must have strong interpersonal skills for interacting with providers and insurance plan representatives.
• Must have strong organizational skills.
• Ability to work independently and meet deadlines.
• Abide by principles of EEO compliance and a workplace of dignity and respect.
• Abide by core values and mission statement of the agency.
• Proficiency in Microsoft Suites.

Nice To Haves

• Preferred experience using electronic billing systems, clearinghouses, payer portals, and electronic health record platforms.
• Preferred knowledge and understanding of trauma-informed principles and practices, including the importance of creating a safe environment, fostering trust, promoting collaboration, and empowering individuals.

Responsibilities

• Prepare, review and submit credentialing and enrollment applications and associated documentation in accordance with insurance plan payer network enrollment and renewal requirements.
• Track, monitor, and maintain credentialing and recredentialing deadlines for providers, programs, and locations for the organization to ensure continuous plan participation and compliance.
• Communicate proactively with providers, payers, and internal teams regarding credentialing status, updates, and delays.
• Confirm licenses, education, training, and certifications of behavioral health and healthcare providers.
• Update internal and external credentialing databases to reflect current status and upcoming renewals, including but not limited to CAQH, NPPES, payer portals as applicable; conduct regular audits to ensure data accuracy.
• Ensure compliance with state, federal, and accreditation standards (i.e., COA).
• Maintain HIPAA compliance and confidentiality at all times.
• Support billing system setup, payer portal setup, workflow development, and process improvement as the organization grows.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED