Earn up to $1,750 in retention bonus in your first year, plus annual bonuses based on tenure!

We invest in our team and provide opportunities for growth, support, and work-life balance!

• Health/Dental/Vision Insurance - 85% company paid for employee coverage (available after 60 days).
• 401(k) Matching Plan - 50% match up to 6% of your annual salary.
• Paid Time Off - 8 hours of vacation & sick leave accrued monthly, plus a floating holiday each year.
• Retention Bonus - Earn up to $1,750 in your first year and annual bonuses based on tenure!
• 11 Paid Holidays - Enjoy time with family and recharge!
• Aspiring Leaders Program - Build your leadership skills and advance in your career!

At Starting Point Behavioral Healthcare, every team member is valued and respected.

Ready to Make a Meaningful Impact? Apply Today!

If you're looking for a rewarding career where you can change lives and grow professionally, we'd love for you to join our team!

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Successful completion of Background, MVR and Drug Free Workplace Screenings.

EDUCATION and/or EXPERIENCE

Master's degree (M. A.) or equivalent with two to four years' experience or a Bachelor's degree with four to ten years related experience and/or training; or equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

Valid Florida driver's license.

SUMMARY

The Credentialing Specialist is responsible for managing the end-to-end credentialing, enrollment, and re-credentialing processes for all licensed, certified, and registered behavioral health providers to ensure compliance with federal, state, payer, and organizational requirements. This role serves as the primary point of contact for internal staff, external credentialing consultants, and payers, ensuring providers are properly credentialed and enrolled to bill Medicaid, Medicare, and commercial insurers.

This is a highly autonomous, process-driven role requiring strong attention to detail, consistency, and comfort with repetitive workflows. The Credentialing Specialist maintains accurate provider records, tracks applications to completion, manages continuing education compliance, supports billing validation, and monitors regulatory and payer websites to ensure ongoing compliance.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Credentialing and Application Management

• Create, manage, and maintain credentialing applications and workflows from initiation through approval for all new and existing providers.

• Track credentialing and re-credentialing applications to completion, ensuring timely follow-up and resolution of outstanding items.

• Serve as the designated point of contact for all Starting Point staff applications and supporting documents.

• Work with external credentialing consultants as needed to support payer enrollment and credentialing activities.

Provider Enrollment and Payer Compliance

• Manage provider enrollment with Medicaid, Medicare, and commercial insurance plans, including initial enrollment and re-credentialing.

• Monitor payer and credentialing websites to ensure compliance with state, federal, and payer-specific requirements.

• Ensure providers are accurately listed in payer directories associated with Starting Point Behavioral Healthcare and update contracts and provider information online as required.

• Collaborate with billing staff to test provider credentialing with payers, identify errors, and correct enrollment issues.

License, Credential, and CEU/CME Management

• Maintain and monitor all provider credentials, licenses, certifications, malpractice insurance, and registrations to ensure active and compliant status.

• Track continuing education units (CEUs) and continuing medical education (CME) requirements for credentialed employees and ensure ongoing compliance.

• Monitor registered interns' progress toward licensure and maintain accurate documentation of licensure milestones.

Data, Tracking, and Documentation

• Maintain accurate and up-to-date provider records, credentialing files, and master provider lists.

• Monitor the provider master list and remove employees no longer associated with the organization.

• Utilize credentialing systems and software (e.g., CAQH and payer portals) to manage provider data and documentation.

• Ensure all credentialing documentation meets standards set by Medicaid, Medicare, commercial payers, NCQA, Joint Commission, and other applicable regulatory bodies.

Collaboration and Liaison Functions

• Serve as the primary liaison between providers, leadership, billing, external credentialing consultants, and insurance companies.

• Coordinate with the Director of Administrative Services and external consultants to streamline credentialing workflows and resolve complex issues.

• Provide guidance to providers and staff regarding credentialing requirements, timelines, and documentation needs.

Compliance

• Perform ongoing quality checks to ensure accuracy and completeness of credentialing data.

• Support audits, payer reviews, and compliance inquiries related to provider credentialing.

SUPERVISORY RESPONSIBILITIES

This position does not have formal supervisory responsibilities but serves as the functional lead for credentialing processes and provides guidance and coordination to providers, staff, and external consultants related to credentialing and enrollment activities.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ETHICAL STANDARDS OF PROFESSION:

• The ability to comply with equal employment opportunity requirements;

• The ability to comply with all federal, state, and local laws at all times;

• The ability to comply with a workplace of dignity and respect;

• The ability to comply with HIPAA requirements for protected healthcare information;

• The ability to take direction and guidance in a respectful manner from managers and supervisors;

• The ability to comply with the code of conduct and ethics and interact respectfully, professionally in a teamwork setting.