Managed Care Provider Credentialing Specialist II - Experience Required

Burrell Behavioral Health; Springfield (MO); Remote; USD 25,000 - 36,000; Full time

Benefits offered by this job

Paid time off

Health benefits

Dental benefits

Vision benefits

Retirement plan

Life insurance

Employee discounts

Job summary

Centerstone is seeking a Managed Care Credentialing Representative II for a remote role to guide providers through credentialing and recredentialing, verify qualifications, and maintain compliant records. You will collaborate with providers and internal teams to ensure timely, accurate processing.

The role requires prior credentialing experience, strong attention to detail, and proficiency in Microsoft Excel. Remote work is supported across the organization.

Qualifications

• Healthcare provider credentialing experience required.
• Experience processing detailed applications and maintaining accurate records.
• Familiarity with payer requirements, regulatory compliance, and primary-source verification.
• Strong Microsoft Excel skills and remote-work capability.

Responsibilities

• Guide providers through initial credentialing and recredentialing processes.
• Verify education, licensure, certifications, and professional history.
• Maintain accurate provider profiles and credentialing databases.
• Monitor deadlines, documentation gaps, and expiring credentials to prevent delays.
• Coordinate with providers and internal/external teams to resolve issues.

Skills

Credentialing experience

Detail orientation

Remote work capability

Communication skills

Education

High school diploma or GED

Administrative data-management background

Tools

Microsoft Excel

Job description

Job Description:Job Title: Managed Care Credentialing Representative IILocation: Remote / Work from HomeDepartment: Managed CareEmployment Type: Full-TimePay Range: $17.93-$26.01 per hour, based on relevant experience and work locationQualification Overview:Required: Previous healthcare provider credentialing experienceRequired: Professional experience in an administrative, office, data-management, insurance, billing, claims, healthcare, financial, or similarly detail-focused business environmentStrongly Preferred: Healthcare revenue cycle experience, including patient billing, insurance claims, collections, or reimbursementPreferred: Provider enrollment, payer enrollment, managed care, privileging, or recredentialing experienceJoin a Recognized Top WorkplaceCenterstone is a nationally recognized behavioral health organization and has been named a Top Workplace in consecutive years, including 2025 and 2026. Top Workplaces recognition is based entirely on confidential employee feedback and reflects the workplace culture, engagement, and employee experience created by the people who work here.Learn more about working at CenterstoneJob Summary:Bring your healthcare credentialing experience, attention to detail, and ability to manage complex information to a remote role that helps qualified providers deliver care. As a Managed Care Credentialing Representative II, you’ll guide providers through initial credentialing and recredentialing, verify professional qualifications, maintain accurate records, and help ensure compliance with payer, regulatory, and organizational requirements.This position is designed for candidates with previous healthcare provider credentialing experience and professional experience managing detailed records, applications, documentation, and deadlines. You’ll collaborate with providers, internal teams, and external organizations while supporting accurate, efficient, and compliant credentialing processes.This position offers…Competitive Pay – $17.93-$26.01 per hour, based on relevant experience and work locationEmployee Assistance Program – 24/7 counseling services, legal assistance, & financial consultation for you and your household at no costMileage Reimbursement – Company paid for work functions requiring travelEmployee Discounts – Hotels, Theme Parks & Attractions, College TuitionWorkplace Culture – An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting a healthy, joyful workforceRemote Work Opportunity – Work from home while supporting providers and teams across the organizationAdditional Perks & Benefits – Scroll down to bottom of this post to learn moreKey Responsibilities:Guide providers through initial credentialing, recredentialing, enrollment, and application processes while providing clear and responsive supportComplete credentialing and recredentialing applications accurately and within required regulatory, contractual, and organizational timelinesVerify provider education, training, licensure, certifications, professional history, privileges, and other required credentialsMaintain accurate provider profiles, credentialing databases, applications, verification records, and supporting documentationMonitor application progress, expiring credentials, outstanding documentation, and recredentialing deadlines to prevent delaysInvestigate discrepancies, adverse findings, and incomplete information and communicate concerns to supervisors or leadership when appropriateCoordinate with providers and internal stakeholders to obtain documentation, update license or privilege information, and resolve credentialing issuesSupport external privileging, managed care requirements, payer requests, audits, and other compliance-related activitiesResearch credentialing standards, payer requirements, and industry policies and translate findings into clear action stepsProtect provider data and maintain confidentiality, accuracy, compliance, and complete audit-ready recordsEducation, Experience, and/or Credential Qualifications:RequiredHigh school diploma, GED, or equivalentPrevious professional experience in healthcare provider credentialingProfessional experience in an administrative, office, data-management, insurance, billing, claims, healthcare, financial, or similarly detail-focused business environmentExperience processing detailed applications, verifying documentation, maintaining accurate records, and meeting established deadlinesProfessional proficiency with Microsoft Office applications, including Microsoft ExcelAbility to work independently in a remote environment with strong organization, time management, and follow-throughPreferredHealthcare revenue cycle experience, including patient billing, insurance claims, collections, payment processing, reimbursement, or related payer functionsExperience with provider enrollment, payer enrollment, managed care, privileging, delegated credentialing, or revalidationExperience communicating with commercial insurance carriers, Medicaid, Medicare, managed care organizations, healthcare providers, or external privileging organizationsKnowledge of provider credentialing standards, payer requirements, regulatory compliance, and primary-source verificationAdvanced Microsoft Excel experience, including sorting, filtering, formulas, data validation, and tracking large amounts of informationExperience working remotely in credentialing, healthcare administration, provider enrollment, payer operations, or revenue cycleAdditional Qualifications:Exceptional organization, accuracy, follow-through, and attention to detailStrong written and verbal communication and customer-service skillsAbility to research credentialing and payer policies and convert complex requirements into actionable stepsAbility to manage multiple providers, applications, deadlines, projects, and stakeholder requests simultaneouslyStrong analytical, auditing, problem-solving, and process-improvement skillsAbility to identify and appropriately escalate adverse, questionable, or incomplete credentialing informationAbility to protect confidential provider, organizational, and healthcare informationReliable professional workspace and ability to collaborate effectively in a remote environmentCurrent driver’s license, acceptable driving record, and current auto insurancePhysical Requirements:Perform primarily sedentary work in a remote environment involving extended periods of sitting and computer useFrequently use hands, fingers, and arms for typing, data entry, application processing, and electronic communicationOccasionally stand, walk, or move materials weighing up to 10 poundsPerform the essential functions of the position with or without reasonable accommodationHelp Qualified Providers Deliver CareAccurate healthcare credentialing protects patients, supports regulatory compliance, and helps qualified providers begin serving communities without unnecessary delays. If you have the required healthcare credentialing experience and the organization, judgment, and attention to detail needed to manage complex provider information, we encourage you to apply and grow with our remote Managed Care team.Position Perks & Benefits:Paid time off: full-time employees receive an attractive time off package to balance your work and personal lifeEmployee benefits package: full-time employees receive health, dental, vision, retirement, life, & moreTop-notch training: initial, ongoing, comprehensive, and supportiveCareer mobility: advancement opportunities/promoting from withinWelcoming, warm, supportive: a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happinessBrightli is on a Mission:A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance user care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.As a behavioral and community mental health provider, we prioritize fostering a culture of belonging and connection within our workforce. We encourage applications from individuals with varied backgrounds and experiences, as we believe that a rich tapestry of perspectives strengthens our mission. If you are passionate about empowering local communities and creating an environment where everyone feels valued and supported, we invite you to join our mission-driven organization dedicated to cultivating an authentic workplace.We are an Equal Employment Opportunity Employer.Brightli is a Smoke and Tobacco Free Workplace.