Credentialing & Enrollment Specialist

Walker Health Services, a medical billing company providing revenue cycle support to healthcare organizations, is seeking an experienced Credentialing & Enrollment Specialist with strong Virginia FFS/MCO experience, preferably within ARTS (Addiction and Recovery Treatment Services). 

This role is responsible for end-to-end facility and provider enrollment and credentialing, with a primary focus on Virginia Medicaid, including ARTS programs, residential treatment facilities, and ORP providers, and secondary exposure to select commercial payers. Medicaid facility enrollment experience is required and is a core function of this role. 

The Credentialing & Enrollment Specialist will serve as a key liaison between clients, providers, and payers, ensuring accurate enrollment, timely revalidations, and ongoing compliance with payer, state, and federal requirements. 

Key Responsibilities 

• Lead facility-level enrollment, credentialing, revalidation, and maintenance with Virginia Medicaid FFS/MCOs, including ARTS programs and residential treatment facilities. 
• Manage initial enrollments, revalidations, changes of information, ownership updates, service additions, and terminations. 
• Coordinate enrollment sequencing between licensure, Medicaid enrollment, and payer credentialing to avoid reimbursement delays. 
• Enroll, credential, and maintain individual providers, with a strong emphasis on ORP providers, including proper linkage to enrolled facilities. 
• Manage provider onboarding, offboarding, role changes, and reassignments across Medicaid and commercial payers. 
• Track and manage provider recredentialing and revalidation cycles to prevent lapses. 
• Obtain and maintain provider authorizations, attestations, and documentation, including CAQH profiles and payer portals. 
• Serve as a point of contact for credentialing and enrollment matters. 
• Monitor application status, follow up with payers, resolve deficiencies, and escalate issues as needed. 
• Maintain strong working relationships with payer representatives; existing payer relationships are preferred. 
• Maintain accurate and complete credentialing and enrollment records across Medicaid portals, CAQH, payer systems, and internal tracking tools. 
• Ensure all records are audit-ready and updated timely. 
• Review payer directories and enrollment listings to ensure accuracy. 
• Meet or exceed internal timelines and payer deadlines. 

Required Qualifications 

• 2–5 years of credentialing and enrollment experience, with direct Virginia Medicaid experience. 
• Demonstrated experience with facility enrollment and ongoing maintenance (not provider-only credentialing). 
• Strong knowledge of ORP provider enrollment and maintenance. 
• Ability to manage revalidations, changes of information, and compliance-driven updates. 
• High attention to detail, strong organizational skills, and ability to manage multiple enrollments simultaneously. 

Preferred Qualifications 

• Experience working with ARTS programs, behavioral health, SUD, or residential treatment settings. 
• Experience with Virginia Medicaid MCOs and select commercial payers. 
• Established working relationships with DMAS or payer credentialing departments. 
• Experience supporting multiple clients in a billing or third-party services environment. 

Location & Compensation 

• Work Location: Hybrid preferred (Pikesville, MD 21208); remote considered for highly qualified candidates 
• Salary Range: $70,000 – $80,000 (commensurate with experience) 

Salary : $70,000 - $80,000