Credentialing Specialist

Behavioral Innovations; Plano (TX); Hybrid; USD 30,000 - 39,000; Full time

Benefits offered by this job

PTO & holidays

Health benefits

EAP program

Family-centered culture

Award-winning culture

Mission-driven work

Inc 5000 recognition

Impact in ABA care

Job summary

Behavioral Innovations is seeking a Credentialing Specialist in Plano, TX, to manage provider credentialing and enrollment processes. The role ensures clinicians are enrolled with payors and reimbursed on time, while auditing records and coordinating with revenue cycle, HR, and leadership to support onboarding.

The position offers a hybrid work model with initial onsite training and flexibility based on performance.

Qualifications

• 3+ years of provider credentialing and enrollment experience.
• Associates degree or related work experience may substitute for education.
• 1–3 years in behavioral health or medical clinic setting preferred.
• Familiarity with EMR and billing systems.
• Strong communication and interpersonal skills.
• Take initiative to identify and resolve issues.
• Excellent organizational, problem-solving and follow-up skills.
• Proficiency in MS Word and Excel.

Responsibilities

• Oversee full credentialing and enrollment for providers.
• Maintain and audit provider records for accuracy and compliance.
• Process enrollment and revalidation applications with payors.
• Coordinate with revenue cycle, HR, and clinical leadership to onboard providers.
• Ensure HIPAA and regulatory compliance and support out-of-state Medicaid enrollments.
• Respond to provider inquiries within 24 hours.

Skills

Credentialing & Enrollment

EMR systems

Billing systems

Communication skills

Proactive problem-solving

Organizational skills

MS Word & Excel

Education

Associates degree or related work experience

Tools

EMR software

Billing software

Job description

Overview

Credentialing Specialist

Applicants must have at least 3 years of recent provider credentialing and enrollment experience

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.

Be an Credentialing Specialist at Behavioral Innovations. Where Potential Thrives.