Credentialing Specialist - [Remote]

AMERICAS REHAB CAMPUSES LLC•Phoenix, AZ

4d•Remote

About The Position

The Credentialing Specialist is responsible for coordinating and managing provider and facility credentialing, enrollment, recredentialing, and payer participation activities for America’s Rehab Campus (ARC). This position works closely with AHCCCS, commercial insurance carriers, and internal departments to ensure providers and facilities remain compliant, credentialed, and eligible for billing and network participation. The Credentialing Specialist maintains accurate credentialing records, monitors expiration dates and regulatory requirements, submits applications and updates, and assists with compliance and audit readiness. This role requires strong attention to detail, knowledge of AHCCCS and behavioral health credentialing requirements, and the ability to work independently in a remote environment while managing multiple deadlines and priorities.

Requirements

High School Diploma or Equivalent required
Minimum of 2 years of credentialing experience required
Experience with AHCCCS provider enrollment and behavioral health credentialing strongly preferred
Knowledge of provider and facility credentialing processes for commercial and government payers
Experience with CAQH, NPPES/NPI Registry, sanction monitoring, and license verification systems
Understanding of healthcare compliance standards and payer requirements
Experience credentialing behavioral health providers and facilities
Familiarity with Joint Commission and AHCCCS compliance requirements
Strong attention to detail and organizational skills
Ability to manage multiple deadlines and prioritize workload independently
Strong written and verbal communication skills
Proficient with Microsoft Office, credentialing software, and electronic document management systems
Ability to maintain confidentiality and handle sensitive information appropriately
Minimum two (2) years of experience in behavioral health field preferred
Successful clearance of pre-employment criminal/county/state background check
Successful clearance of pre-employment drug and alcohol testing

Nice To Haves

CPCS, CPMSM, or related credentialing certification preferred but not required

Responsibilities

Complete and manage provider credentialing and recredentialing applications with AHCCCS, commercial insurance carriers, and contracted networks
Coordinate facility credentialing, enrollment, and updates for behavioral health programs and locations
Maintain credentialing files and ensure all required documentation remains current and compliant
Monitor expiration dates for licenses, certifications, malpractice insurance, DEA registrations, CAQH attestations, and other required credentials
Submit and track AHCCCS provider enrollment applications, updates, and revalidations
Work with insurance payers regarding contracting, participation status, and credentialing follow-up
Maintain provider records within credentialing databases and internal tracking systems
Verify provider credentials including licenses, education, certifications, NPI numbers, sanctions, exclusions, and background screening requirements
Coordinate with HR, Compliance, Revenue Cycle, and Operations regarding onboarding and credentialing status
Assist with audits, surveys, and compliance requests related to credentialing documentation
Maintain knowledge of AHCCCS requirements, payer standards, and behavioral health credentialing regulations
Communicate credentialing updates and deficiencies to leadership and providers in a timely manner
Ensure credentialing timelines are met to avoid interruptions in billing or payer participation