Demo

FT Credentialing Specialist - Hybrid

Acadia Behavioral Health (Pioneer Behavioral Health)
Tucson, AZ Full Time
POSTED ON 4/26/2025
AVAILABLE BEFORE 6/26/2025
ID: 2025-68548 # of Openings: 1 Job Family: Operations

Overview

HYBRID: 3 days in the office at Sierra Tucson, 2 days remote

SCHEDULE: Monday - Friday, hours are flexible

PURPOSE STATEMENT:

The primary duty of the Credentialing Specialist is to manage the credentialing portion of the internal credentialing and provider enrollment process for individual providers/clinicians. They will partner with facilities, providers/clinicians, and field leadership to prepare the proper documentation for initial and re-credentialing application submissions to meet required deadlines, assist in the completion of Medicaid enrollments, and will be responsible for completing enrollment for any other payors as needed. The Credentialing Coordinator maintains the department workflow to ensure accuracy and completion of tasks in a timely manner.

Responsibilities

ESSENTIAL FUNCTIONS:

  • Request and review key credentialing file documentation for each provider/clinician.
  • Review and complete Primary Source Verification for all vital credentialing file documentation.
  • Prepare and submit initial and re-credentialing documentation for each payor as needed.
  • Track and monitor incoming and outgoing credentialing requests, including maintenance of credentialing files.
  • Maintain various database systems.
  • Prepare and submit state Medicaid and other payor enrollments and re-validations.
  • Work directly with payers, the CBOs, and Contracting Departments to resolve disputes.
  • Prepare and administer routine correspondence, memoranda, and notifications.
  • Work closely with the CBOs and Contracting Departments to ensure efficiency of processes and create new workflow tools as needed.
  • Update and maintain in-house documents.
  • OTHER FUNCTIONS:

    · Performs other duties as assigned.

    STANDARD EXPECTATIONS:

    • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
    • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
    • Develops constructive and cooperative working relationships with others and maintains them over time.
    • Encourages and builds mutual trust, respect and cooperation among team members.
    • Maintains regular and predictable attendance.

    Qualifications

    EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

    · BA/BS degree preferred.

    · 1 – 3 years of healthcare related experience required.

    · 1 – 3 years healthcare credentialing experience preferred.

    · Basic to working knowledge of contracting concepts.

    · Must be proficient in Microsoft Word and Excel.

    · Documentation, proficiency, attention to detail, and organization skills are essential.

    · Ability to multi-task is a must

    LICENSES/DESIGNATIONS/CERTIFICATIONS:

    · Not Applicable

    SUPERVISORY REQUIREMENTS : This position is an Individual Contributor

    While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

    We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

    STU01

    #LI-ST

    If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a FT Credentialing Specialist - Hybrid?

    Sign up to receive alerts about other jobs on the FT Credentialing Specialist - Hybrid career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $45,655 - $57,431
    Income Estimation: 
    $52,651 - $65,671
    Income Estimation: 
    $45,655 - $57,431
    Income Estimation: 
    $52,651 - $65,671
    Income Estimation: 
    $52,651 - $65,671
    Income Estimation: 
    $70,470 - $90,625
    Income Estimation: 
    $98,508 - $127,023
    Income Estimation: 
    $163,457 - $212,608
    Income Estimation: 
    $70,470 - $90,625
    Income Estimation: 
    $98,508 - $127,023
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at Acadia Behavioral Health (Pioneer Behavioral Health)

    Acadia Behavioral Health (Pioneer Behavioral Health)
    Hired Organization Address Tucson, AZ Other
    Employment Type: Part-Time The Outpatient Therapist is responsible for diagnosing and treating mental and emotional diso...
    Acadia Behavioral Health (Pioneer Behavioral Health)
    Hired Organization Address Mesa, AZ Full Time
    Employment Type: Full-Time Hours Per Week: 36 Provide nursing care and services within the standards and scope of nursin...
    Acadia Behavioral Health (Pioneer Behavioral Health)
    Hired Organization Address Chandler, AZ Other
    ID: 2025-69435 # of Openings: 1 Job Family: Medical Records Overview PURPOSE STATEMENT: Perform clerical duties associat...
    Acadia Behavioral Health (Pioneer Behavioral Health)
    Hired Organization Address Chandler, AZ Other
    ID: 2025-69312 # of Openings: 1 Job Family: RN Nurse Overview PRN RN Days/Nights - Behavioral Health $44/hour for standa...

    Not the job you're looking for? Here are some other FT Credentialing Specialist - Hybrid jobs in the Tucson, AZ area that may be a better fit.

    AHCCCS Billing/Coding/Credentialing Specialist

    PEOPLES HEALTH CARE CONNECTION LLC, Tucson, AZ

    AI Assistant is available now!

    Feel free to start your new journey!