Credentialing Specialist

Archdiocese of St. Louis•Riverview, MO

20d

About The Position

Saint Louis Counseling, part of Catholic Charities St. Louis, is seeking a mission-driven, part-time Credentialing Specialist to support clinicians and expand access to behavioral health services. The role manages provider credentialing, enrollment, and recredentialing with Medicare, Medicaid, commercial insurance plans, and other third-party payers to help ensure uninterrupted provider participation, compliance, and reimbursement. The position is 20 hours per week and starts at $25 per hour. Saint Louis Counseling supports healing and improved mental health for families and children of all backgrounds through professional counseling and psychiatric services. It operates eight offices throughout metropolitan St. Louis, and its School Partnership Program provides onsite services at more than 100 schools and at area shelters serving children who are homeless.

Requirements

High school diploma or equivalent required.
Experience managing provider enrollment, credentialing, and recredentialing processes.
Knowledge of Medicare, Medicaid, commercial insurance, and other third-party payer credentialing requirements.
Experience using CAQH, NPPES, PECOS, and payer enrollment portals.
Experience using credentialing, provider enrollment, practice management, or related healthcare software.
Familiarity with behavioral health, counseling, healthcare, or medical practice operations.

Nice To Haves

Associate's degree preferred.
A minimum of 4 years of healthcare credentialing, provider enrollment, medical billing, or related experience is preferred.

Responsibilities

Coordinate provider enrollment, credentialing, recredentialing, and disenrollment activities for Medicare, Medicaid, commercial insurance payers, and other third-party reimbursement programs.
Prepare, submit, and track credentialing, recredentialing, payer enrollment, demographic update, and provider maintenance applications through approval and implementation.
Maintain accurate and complete provider records, credentialing files, and enrollment documentation in credentialing databases, payer portals, and other designated systems.
Monitor credentialing application, payer enrollment, and provider participation status to ensure timely completion and uninterrupted network participation.
Track expiration and renewal dates for licenses, certifications, malpractice insurance, DEA registrations, and other required credentials, and obtain updated documentation as necessary.
Research payer requirements, regulatory changes, and enrollment guidelines, and communicate updates that may affect provider participation, reimbursement, or compliance.
Collaborate with providers, payer representatives, billing staff, and internal stakeholders to resolve credentialing discrepancies, enrollment issues, and participation delays.
Verify payer participation status, effective dates, and provider enrollment information to support accurate billing and reimbursement.
Coordinate adding new providers and service locations, and provider changes, with applicable payer networks.
Prepare credentialing reports, enrollment status updates, and related data for leadership and operational stakeholders.
Support internal audits, external reviews, accreditation activities, and compliance initiatives by maintaining complete, accurate, audit-ready documentation.
Perform other related duties as assigned.