Credentialing Specialist

Job Description

Job Description

About DeCoach Recovery

DeCoach Recovery is dedicated to helping individuals achieve long-term recovery through compassionate, evidence-based behavioral health and substance use treatment. Our multidisciplinary team works together to provide quality care that empowers patients to rebuild their lives and strengthen our communities.

Position Overview

We are seeking a detail-oriented and organized Credentialing Specialist to join our growing administrative team. This individual will be responsible for managing and maintaining provider credentialing and re-credentialing with insurance payers, regulatory agencies, and internal systems. The ideal candidate has a strong understanding of healthcare credentialing, payer enrollment processes, and compliance requirements.

Key Responsibilities

Coordinate and complete initial credentialing, re-credentialing, and enrollment processes for all providers and facilities.

Prepare and submit applications to insurance networks, Medicaid / Medicare, and other payers.

Maintain accurate provider records and credentialing databases to ensure compliance with company and regulatory standards.

Track application statuses, follow up with payers, and resolve delays or discrepancies in a timely manner.

Manage provider files, including licenses, certifications, DEA registrations, and background checks.

Ensure timely renewals and revalidations to prevent lapses in credentialing.

Collaborate with HR, billing, and compliance departments to ensure data integrity and operational efficiency.

Stay up to date with payer requirements, credentialing regulations, and industry best practices.

Qualifications

Required :

High school diploma or equivalent (Associate’s or Bachelor’s degree preferred).

2+ years of experience in healthcare credentialing, payer enrollment, or a related administrative role.

Strong understanding of credentialing standards (e.g., CAQH, NPPES, PECOS, Medicaid / Medicare).

Excellent attention to detail and organizational skills.

Proficiency with Microsoft Office and credentialing management software.

Preferred :

Experience in behavioral health or substance use treatment settings.

Familiarity with Joint Commission, CARF, or state-level compliance standards.

CPCS or CPMSM certification a plus.

Why Join DeCoach Recovery?

Mission-driven organization focused on changing lives.

Supportive, collaborative, and inclusive work culture.

Opportunities for professional development and growth.

Competitive pay and comprehensive benefits package (medical, dental, vision, PTO, etc.).

ome part of our compassionate and dynamic team.