Credentialing Specialist

North Homes Children & Family Services•Grand Rapids, MN

5d•$22 - $27

About The Position

We are seeking a detail-oriented Part-Time Credentialing Specialist to support our behavioral health programs by managing both provider and facility credentialing processes. This role ensures compliance with state and federal regulations, payer requirements, and accreditation standards. The ideal candidate understands the critical role credentialing plays in behavioral health service delivery and demonstrates exceptional organization and discretion. Key responsibilities of this position include: Provider Credentialing Manage initial credentialing and re-credentialing for licensed and unlicensed behavioral health providers Maintain complete and accurate provider credentialing files in accordance with: State licensing requirements DHS and county contracting standards Accreditation bodies (CARF, COA, etc., if applicable) Payer and managed care organization requirements Conduct primary source verifications (licenses, education, certifications) Track licensure, certifications, trainings, background studies, and supervision documentation Prepare and submit payer enrollment and revalidation applications Monitor expiration dates and proactively communicate renewal requirements Facility Credentialing Manage facility credentialing and re-credentialing with payers and regulatory bodies Maintain facility licensure, certifications, and compliance documentation Track facility-level requirements including: Licenses and permits Accreditation status Inspections and site visit documentation Prepare and submit facility enrollment and revalidation applications Coordinate with leadership on site visits, audits, and payer reviews Ensure facility records remain current and audit-ready General Compliance Duties Ensure compliance with HIPAA and data privacy standards Support internal and external audits and site visits Maintain credentialing databases and tracking systems Collaborate with HR, Clinical Leadership, QA, and Compliance teams Identify opportunities to improve credentialing workflows and tracking systems

Requirements

Associate’s degree or equivalent experience preferred
Experience in healthcare or behavioral health credentialing preferred
Knowledge of state licensing boards, behavioral health regulatory requirements, and payer enrollment processes
Strong attention to detail and documentation accuracy
Ability to manage competing deadlines
Excellent communication skills
Proficiency in Microsoft Office and credentialing systems
Experience with CAQH, NPI registry, and payer portals preferred
Ability to handle PHI and confidential data professionally

Responsibilities

Manage initial credentialing and re-credentialing for licensed and unlicensed behavioral health providers
Maintain complete and accurate provider credentialing files in accordance with state licensing requirements, DHS and county contracting standards, accreditation bodies, and payer requirements
Conduct primary source verifications (licenses, education, certifications)
Track licensure, certifications, trainings, background studies, and supervision documentation
Prepare and submit payer enrollment and revalidation applications
Monitor expiration dates and proactively communicate renewal requirements
Manage facility credentialing and re-credentialing with payers and regulatory bodies
Maintain facility licensure, certifications, and compliance documentation
Track facility-level requirements including licenses and permits, accreditation status, and inspections and site visit documentation
Prepare and submit facility enrollment and revalidation applications
Coordinate with leadership on site visits, audits, and payer reviews
Ensure facility records remain current and audit-ready
Ensure compliance with HIPAA and data privacy standards
Support internal and external audits and site visits
Maintain credentialing databases and tracking systems
Collaborate with HR, Clinical Leadership, QA, and Compliance teams
Identify opportunities to improve credentialing workflows and tracking systems