Credentialing Specialist

Behavioral Innovations•Addison, TX

8h•Hybrid

About The Position

Behavioral Innovations is a fast-growing team and leading provider of Applied Behavior Analysis (ABA) therapy for children with autism, ages 18 months to 10 years, with over 100+ locations across TX, OK, CO, VA, MD. The company was named Company of the Year in 2022 and ranked on the Inc. 5000 list for three consecutive years. The Credentialing Specialist will oversee the full credentialing and enrollment process for providers in Behavioral Healthcare, ensuring accurate enrollment with commercial and government payors for timely service reimbursement. This role involves maintaining and auditing provider records, processing enrollment and revalidation applications, and consistent follow-up with payors. The specialist will collaborate with revenue cycle, clinical leadership, HR recruitment, and providers to support smooth onboarding and resolve credentialing issues. Additionally, the role manages provider contracting, ensures HIPAA and regulatory compliance, assists with out-of-state Medicaid enrollments, and responds to provider inquiries within 24 hours. This position directly strengthens operational efficiency, reimbursement accuracy, and timely access to care.

Requirements

Associates degree and three (3) years relevant experience in credentialing or related work experience may be substituted in lieu of educational qualifications
Familiarity with Electronic Medical Records (EMR) and billing systems
Strong communication and interpersonal skills to collaborate with internal teams and external payors
Take the initiative to identify and resolve issues
Excellent organizational, problem-solving, and follow-up skills
Proficiency in Microsoft Word and Excel

Nice To Haves

1-3 years of knowledge in a behavioral health or medical clinic setting
Experience in provider enrollment, credentialing, or revenue cycle management

Responsibilities

Oversee the full credentialing and enrollment process for providers in Behavioral Healthcare
Ensure clinicians are accurately enrolled with commercial and government payors so services can be reimbursed on time
Maintain and audit provider records
Process enrollment and revalidation applications
Conduct consistent follow-up with payors
Partner closely with revenue cycle, clinical leadership, HR recruitment, and providers to support smooth onboarding and resolve credentialing issues
Manage provider contracting
Ensure HIPAA and regulatory compliance
Assist with out-of-state Medicaid enrollments
Respond to provider inquiries within 24 hours

Benefits

Hourly rate compensation
10 days PTO
7 paid holidays
Medical Insurance
Vision Insurance
Dental Insurance
Supplemental Insurance Policies
Tools and programs to support physical, mental, and emotional wellness
Employee Assistance Program (EAP)
Family-Centric Culture: Caring, collaborative environment
Award-Winning Culture: Recognized for clinical excellence and ethical standards
Mission-Driven Work: Help children with autism reach their full potential
Values-Driven Organization: Caring, accountability, collaboration, and family-focused care
Recognized Industry Leader: Named Company of the Year in 2022
National Recognition: Proudly ranked on the Inc. 5000 list as one of America’s Fastest Growing Private Companies — for 3 consecutive years!