Credentialing Coordinator, FT, Days

Connections Health Solutions

. Manage the end-to-end credentialing, re-credentialing, and payer enrollment process for behavioral health providers, behavioral health support staff, and facilities .

Posted 10/30/2026full-timeRemote • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the credentialing and payer enrollment processes for behavioral health providers, including proficiency in regulatory requirements and credentialing software. Strong communication skills are essential for effective interaction with physicians and providers.

Highest-signal resume keywords

Credentialing ManagementPayer EnrollmentRegulatory ComplianceCredentialing Software ProficiencyCustomer Service Orientation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingPayer EnrollmentPrimary Source VerificationRegulatory Requirements ResearchDocumentation ManagementData EntryLicensure ManagementMedicaid EnrollmentCredentialing DocumentationMulti-State Credentialing

Soft Skills

Communication SkillsCustomer Service SkillsProblem-Solving SkillsOrganizational SkillsInterpersonal Skills

Tools & Technologies

MedallionPECOSCAQHMicrosoft OfficeCredentialing Management System

Industry Keywords

Behavioral HealthManaged CareMedicareMedicaidCredentialing Committee

About the role

Key responsibilities & impact

Manage the end-to-end credentialing, re-credentialing, and payer enrollment process for behavioral health providers, behavioral health support staff, and facilities
Manage new provider onboarding from HR/Talent Acquisition notification through completion of the Medallion profile
Enter and maintain provider information including NPI, licensure, practice locations, and payer information
Request required documentation including CAQH, PECOS, state licenses, DEA registrations, board certifications, diplomas, and other credentials; track completion
Communicate with physicians and providers by phone, text, and email to explain requirements, resolve outstanding items, and answer questions
Research and interpret state licensing, supervision, collaborative agreement, and scope-of-practice requirements
Complete primary source verifications including NPI, NPDB, Medicare/Medicaid opt-out, state licensure, DEA, OIG, and SAM checks
Escalate adverse findings through the credentialing committee review process
Coordinate malpractice policy additions and upload insurance documentation to the credentialing platform and CAQH
Manage commercial and government payer enrollment applications, effective dates, payer IDs, and recredentialing dates
Maintain and re-attest provider CAQH profiles
Support cross-state licensure and payer enrollment for telehealth providers
Facilitate state and program-specific registrations, Medicaid portal enrollment, domain transfers, surrogacy requests, and Medicare enrollment through CMS/PECOS
Manage NPI acquisition and state Medicaid enrollment for behavioral health support staff; distribute compliance reports
Manage facility-level enrollment and maintenance in state Medicaid systems
Process provider and BHS staff terminations and notify applicable payers
Monitor OIG/SAM and NPDB databases, license renewals, board certifications, and recredentialing cycles
Complete credentialing documentation under delegated credentialing requirements
Partner with HR, Talent Acquisition, Medical Leadership, and operational leadership
Participate in quarterly Credentialing Committee meetings and prepare regular status reporting
Support standardized credentialing workflows, reference guides, process documentation, and SOPs
Perform other duties and responsibilities as assigned

Requirements

What you’ll need

High school diploma or equivalent required
2 years of experience in provider and/or facility credentialing, payer enrollment, or related managed care administrative work
General knowledge of regulatory requirements related to credentialing and payer enrollment, including Medicare, Medicaid, and managed care processes and rules
Ability to research and interpret state licensing board requirements across MD, DO, NP, and PA provider types
Experience working within a credentialing software platform such as Medallion or a comparable credentialing management system
Working knowledge of PECOS, CAQH, and state Medicaid provider portals
Strong customer service orientation and soft skills, with comfort communicating by phone, text, and email with physicians and providers
Advanced user of Microsoft Office products, particularly Excel
Must be fully vaccinated with documentation, or exempt through the company exemption process, prior to start date
Preferred: Bachelor's degree in health care administration or a related field
Preferred: 3+ years of credentialing or payer enrollment experience within a behavioral health environment
Preferred: Familiarity with CAQH attestation processes and delegated credentialing requirements
Preferred: Experience supporting multi-market or multi-state credentialing and enrollment operations

Benefits

Comp & perks

Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity
CHS pays for Basic Life, AD&D, Short and Long-Term Disability
Voluntary Life insurance option for employees and their families
Health Savings Accounts with $1,000 to $2,000 employer contribution depending on plan
Flexible Spending Accounts for health care and dependent care
401k company match after 6 months (50% of deferrals up to 6% of compensation)
Generous PTO starting at 160 hours accrued annually
12 recognized company holidays
Company-paid parental leave available to eligible employees
Employee Assistance Program providing confidential emotional support, work life solutions, financial solutions, legal assistance, and online support
After 90 days, auto-enrollment in the 401k Plan