Credentialing Specialist

Credentialing & Provider Enrollment Specialist

Behavioral Health Hospital Billing

We are hiring a Credentialing & Provider Enrollment Specialist to manage provider credentialing, payer enrollment, and compliance processes for behavioral and mental health providers, including hospital based programs and individual clinicians. The ideal candidate should have strong experience handling commercial and government payer enrollments while ensuring providers remain fully credentialed and billing ready.

Key Responsibilities

• Manage provider credentialing and payer enrollment with commercial payers, Medicare, and Medicaid
• Maintain and update CAQH profiles with timely attestations
• Process CMS 855B / 855I enrollments and PECOS updates
• Handle Group NPI (Type 2) and Individual NPI (Type 1) setup and NPPES linkage
• Verify provider licenses, DEA/CDS certificates, malpractice insurance, and credential documents
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