Credentialing Specialist

Behavioral Innovations (BI); Plano (TX); Hybrid; USD 28,000 - 41,000; Full time

Benefits offered by this job

Competitive hourly rate

10 days PTO

7 paid holidays

Medical, Vision, Dental

Supplemental Insurance

Wellbeing programs

Employee Assistance Program (EAP)

Family-Centric Culture

Award-Winning Culture

Mission-Driven Work

Inc. 5000 recognition

Job summary

Behavioral Innovations is seeking a Credentialing Specialist to oversee the full credentialing and enrollment process for our providers across commercial and government payors, ensuring timely reimbursement. The role collaborates with revenue cycle, clinical leadership, HR recruitment, and providers to maintain records, enroll, revalidate, and resolve issues.

Start onsite in Plano for 90 days, then transition to hybrid scheduling based on performance.

Qualifications

• 3+ years of direct credentialing and enrollment experience in healthcare.
• Associate degree or equivalent experience.
• 1-3 years in a behavioral health setting preferred.
• Familiarity with EMR and billing systems.
• Strong communication and collaboration skills.
• Proactive problem-solver with excellent organizational skills.
• Proficient in Microsoft Word and Excel.

Responsibilities

• Oversee provider credentialing and enrollment processes.
• Maintain and audit provider records.
• Process enrollment and recredentialing applications.
• Follow up with payors to resolve issues.
• Coordinate provider contracting and HIPAA compliance.
• Assist with Medicaid enrollments and regional registrations.
• Respond to provider inquiries within 24 hours.
• Collaborate with revenue cycle, clinical leadership, HR, and providers.

Skills

Credentialing

Enrollment management

Communication

Education

Associate degree

Tools

EMR systems

Billing software

Job description

Credentialing Specialist

Location: Plano, TX (Park/Tollway)

Schedule: Monday-Friday | Full-Time | Hybrid-role, starts onsite full-time during initial 90 day training period, with ability to transition to RCM hybrid scheduled based on performance.

Why Choose Behavioral Innovations:

• Compensation: Competitive Hourly Rate
• Work-Life Balance: 10 days PTO, 7 paid holidays.
• Comprehensive Benefits: Medical, Vision, Dental, and Supplemental Insurance Policies.
• Wellbeing: Tools and programs to support physical, mental, and emotional wellness.
• Employee Assistance Program (EAP): Comprehensive support.
• Family-Centric Culture: Caring, collaborative environment.
• Award-Winning Culture: Recognized for clinical excellence and ethical standards.
• Mission-Driven Work: Help children with autism reach their full potential.
• Values-Driven Organization: Caring, accountability, collaboration, and family-focused care.
• Recognized Industry Leader: Named Company of the Year in 2022, reflecting our continued growth and impact in the ABA field.
• National Recognition: Proudly ranked on the Inc. 5000 list as one of America’s Fastest Growing Private Companies — for 3 consecutive years!

Your Work and How You'll Make a Difference

We are seeking a Credentialing Specialist to oversee the full credentialing and enrollment process for our providers in Behavioral Healthcare. This role ensures clinicians are accurately enrolled with commercial and government payors so services can be reimbursed on time. Responsibilities include maintaining and auditing provider records, processing enrollment and revalidation applications, and conducting consistent follow-up with payors. This position partners closely with revenue cycle, clinical leadership, HR recruitment, and providers to support smooth onboarding and resolve credentialing issues. The role also manages provider contracting, ensures HIPAA and regulatory compliance, assists with out-of-state Medicaid enrollments, and responds to provider inquiries within 24 hours. Your work directly strengthens operational efficiency, reimbursement accuracy, and timely access to care.

Qualifications

• Minimum of 3 years of direct experience managing provider credentialing and enrollment processes within a healthcare environment, including payer enrollment, recredentialing, and compliance with applicable regulatory requirements.
• Associates degree or related work experience may be substituted in lieu of educational qualifications.
• 1-3 years of knowledge in a behavioral health or medical clinic setting preferred, but not necessary.
• Familiarity with Electronic Medical Records (EMR) and billing systems.
• Strong communication and interpersonal skills to collaborate with internal teams and external payors.
• Take the initiative to identify and resolve issues
• Excellent organizational, problem-solving, and follow-up skills.
• Proficiency in Microsoft Word and Excel.

About Behavioral Innovations

Since 2000, Behavioral Innovations (BI) has been a leading provider committed to transforming lives by providing compassionate, center-based Applied Behavioral Analysis (ABA) therapy for children with autism, ages 18 months to 10 years. With more than 100+ locations across TX, OK, CO, VA, MD, NC - and more to come - we’re continuing to expand rapidly. Join our dynamic team and make a meaningful difference in the lives of the families we serve.