Credentialing Specialist

2 weeks ago

Franklin Tennessee, United States Acadia Healthcare Full time

Position Overview:

NOW HIRING:

FULLY REMOTE CREDENTIALING SPECIALIST

About Our Team:
We are dedicated to enhancing the lives we impact.

We seek passionate and skilled individuals who share our commitment to establishing a premier organization that exemplifies excellence in the treatment of specialized behavioral health and addiction disorders.

Acadia Healthcare, a leading provider of behavioral healthcare services in the nation, is headquartered in Franklin, TN. Our organization values employee contributions and promotes collaboration to foster a team-oriented service delivery system.

Our Benefits Include:
Comprehensive medical, dental, and vision insurance

Acadia Healthcare 401(k) plan

Paid time off for vacation and illness

Flexible work hours

Unmatched opportunities for professional growth in the industry

Your Role as a Credentialing Specialist:
The Credentialing Specialist oversees the credentialing aspect of the contracting process.

You will collaborate with facilities to compile the necessary documentation for initial and re-credentialing application submissions to meet essential deadlines, assist in Medicaid enrollment processes, and manage the completion of Powers of Attorney (POAs).

The Credentialing Specialist ensures the department's workflow is maintained for accuracy and timely completion of tasks.

Your Responsibilities as a Credentialing Specialist:
Request and evaluate essential credentialing documentation for each provider/clinician.

Conduct Primary Source Verification for all critical credentialing documentation.

Prepare and submit initial and re-credentialing documentation for each payer as required.

Track and manage incoming and outgoing credentialing requests, including maintaining credentialing files.

Oversee various database systems.

Prepare and submit state Medicaid and other payer enrollments and re-validations.

Engage directly with payers, the Central Billing Offices (CBOs), and Contracting Departments to resolve any disputes.

Draft and manage routine correspondence, memoranda, and notifications.


Collaborate closely with the CBOs and Contracting Departments to enhance process efficiency and develop new workflow tools as necessary.

Update and maintain internal documents.

Your Skills and Qualifications as a Credentialing Specialist:
Bachelor's degree preferred.

Experience with multi-state payer enrollment is essential, requiring minimal assistance/training for the role.

  • Familiarity with state Medicaid and Managed Care Organization (MCO) payer enrollment for initial and re-credentialing applications
  • Effective communication skills with healthcare providers and payers to gather necessary information for enrollment.
  • A minimum of 2 years' experience in credentialing within a healthcare environment.
  • Experience in behavioral health credentialing is advantageous but not mandatory.
  • Knowledge of CredentialingStream/Verity is a plus but not required.
  • Strong organizational and analytical abilities, with a keen attention to detail.
  • Excellent verbal and written communication skills.
  • Ability to prioritize tasks and work independently.
  • Capability to work effectively within a team environment.
  • Proficient in multitasking and performing well under pressure.
  • Ability to meet weekly performance goals.
  • Comfortable in a fast-paced healthcare setting.
  • Willingness to assist colleagues and other departments as needed to complete tasks.
  • Open to contributing to additional projects as required.


We are committed to providing equal employment opportunities to all applicants for employment, regardless of individual characteristics protected by applicable state, federal, and local laws.

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