Credentialing Specialist

Behavioral Innovations•Addison, TX

13d•Hybrid

About The Position

We are seeking a Credentialing Specialist to oversee the full credentialing and enrollment process for our providers in Behavioral Healthcare. This role ensures clinicians are accurately enrolled with commercial and government payors so services can be reimbursed on time. Responsibilities include maintaining and auditing provider records, processing enrollment and revalidation applications, and conducting consistent follow-up with payors. This position partners closely with revenue cycle, clinical leadership, HR recruitment, and providers to support smooth onboarding and resolve credentialing issues. The role also manages provider contracting, ensures HIPAA and regulatory compliance, assists with out-of-state Medicaid enrollments, and responds to provider inquiries within 24 hours. Your work directly strengthens operational efficiency, reimbursement accuracy, and timely access to care.

Requirements

Minimum of 3 years of direct experience managing provider credentialing and enrollment processes within a healthcare environment, including payer enrollment, recredentialing, and compliance with applicable regulatory requirements.
Associates degree 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 preferred, but not necessary.

Responsibilities

Oversee the full credentialing and enrollment process for providers in Behavioral Healthcare.
Ensure clinicians are accurately enrolled with commercial and government payors for timely reimbursement.
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.