Revenue Eligibility & Credentialing Leader

Prince William County Government; Virginia (MN); On-site; USD 76,000 - 105,000; Full time

Benefits offered by this job

VRS Retirement

Paid Leave

Paid Holidays

Medical, Dental, Vision

Life Insurance

Employee Assistance Program

Career Development Opportunities

Job summary

Prince William County Community Services seeks an experienced Eligibility, Credentialing, and Recovery Supervisor to lead revenue-related administrative functions in a behavioral health setting. You will supervise staff, ensure compliance with regulations, oversee Medicaid/benefit eligibility, credentialing, debt recovery, and data analysis, while coordinating with clinical, fiscal, and external stakeholders.

Proficiency with Microsoft Office and health records systems is required.

Qualifications

• High school diploma or GED.
• 6 years of analytical, paraprofessional, healthcare, behavioral health, eligibility, credentialing, financial, revenue recovery, or related administrative experience.
• Experience supervising healthcare or behavioral health staff.
• Knowledge of Medicaid and payer requirements.
• Ability to interpret regulations and manage multiple priorities.

Responsibilities

• Supervises revenue eligibility, financial assessments, Medicaid and benefit eligibility, fee agreements, self-pay, credentialing, and debt recovery operations.
• Ensures compliance with federal, state, local, payer, and agency regulations and financial requirements.
• Leads revenue maximization and recovery efforts by monitoring client status and addressing missed revenue opportunities.
• Oversees Medicaid and other benefit eligibility processes, including renewals and ongoing monitoring.
• Oversees provider credentialing and enrollment to minimize disruptions.
• Directs debt recovery activities and ensures lawful compliance.
• Analyzes operational, financial, and performance data; conducts QA and reconciliations.
• Manages staff performance, training, and development; coordinates with stakeholders.

Skills

Analytical skills

Leadership

Communication

Problem-solving

Decision-making

MS Office

Education

High school diploma or GED

Tools

Electronic Health Records

Microsoft Office

Financial/Administrative systems

Job description

Prince William County Community Services seeks an experienced Eligibility, Credentialing, and Recovery Supervisor to lead revenue-related administrative functions in a behavioral health setting. You will supervise staff, ensure compliance with regulations, oversee Medicaid/benefit eligibility, credentialing, debt recovery, and data analysis, while coordinating with clinical, fiscal, and external stakeholders.

Proficiency with Microsoft Office and health records systems is required.