Credentialing and Provider Enrollment Specialist

We are hiring a Credentialing and Provider Enrollment Specialist to manage provider and organizational credentialing and enrollment with commercial insurance carriers and third‑party payers. This role plays a key part in ensuring our clinicians and facilities remain properly credentialed, so behavioral health services are reimbursed without interruption.

This is a great opportunity for a detail‑driven credentialing professional who enjoys ownership of timelines, payer follow‑up, and cross‑department collaboration.

Key Responsibilities

• Manage initial credentialing and recredentialing for clinical providers, including LPCs, LMSWs, LMFTs, psychologists, physicians, nurse practitioners, physician assistants, and psychiatrists
• Prepare, submit, and track credentialing and enrollment applications with commercial insurance carriers and regional payers
• Maintain accurate provider information in CAQH ProView and payer portals
• Verify licensure, malpractice insurance, DEA registration (as applicable), and other payer requirements
• Track credentialing timelines and proactively follow up to prevent enrollment delays
• Maintain complete and organized credentialing files, approvals, and contracts
• Coordinate facility and group enrollments and ensure proper linkage to individual providers
• Monitor recredentialing deadlines to prevent lapses in enrollment
• Maintain credentialing databases in compliance with regulatory and accreditation standards
• Support audits and respond to payer documentation requests
• Assist with payer contracting activities, including contract review, fee schedules, effective dates, and reimbursement rates
• Partner with billing and clinical leadership to resolve enrollment‑related claim issues and support provider onboarding
• Provide leadership with regular updates on credentialing status and effective dates
• Perform other duties as assigned

Qualifications

Required:

• High school diploma or GED
• At least 2 years of healthcare credentialing experience (behavioral health preferred)
• Experience with commercial insurance carriers
• Familiarity with Medicaid and Medicare enrollment processes
• Proficiency with CAQH ProView, payer portals, and credentialing systems
• Working knowledge of NPI, PECOS (if applicable), and provider enrollment workflows
• Strong organizational skills and attention to detail
• Ability to manage multiple deadlines with minimal errors

Preferred:

• CPCS (Certified Provider Credentialing Specialist) or similar credentialing certification

Skills & Competencies

• Strong written and verbal communication skills
• Effective payer follow‑up and relationship management
• Ability to interpret payer requirements and contractual terms
• High level of professionalism, discretion, and ethical conduct
• Proficiency with Microsoft Office and standard business applications
• Ability to work independently in a fast‑paced environment

Physical Requirements

• Ability to meet attendance and productivity standards in compliance with ADA, FMLA, and applicable regulations
• Ability to lift and carry up to 50 pounds
• Ability to communicate clearly through speaking and listening

Why Join Us

• Stable, full‑time position in a growing behavioral health environment
• Opportunity to work closely with leadership, billing, and clinical teams
• Meaningful role supporting access to behavioral health services through accurate credentialing

Must be able to pass drug screen for illegal substances and background check

Addiction Treatment. Detoxification. Relapse Prevention.

Meridian Health Services helps instill hope and restore health to those suffering from substance use disorders.

Meridian Health Services has been helping individuals suffering from substance use disorders for over 40 years. We use the most advanced, modern, therapeutic practices to treat drug and alcohol addiction. Our success in Addiction Treatment is based on working with individuals to help them learn to live a balanced lifestyle.

Meridian Health Services is the only treatment facility in Michigan to offer an evidence-based treatment curriculum with specialized programming components to treat opiate dependence and poly-substance dependence.

Our treatment philosophy is based on the recognition that alcohol and drug addiction is a disease and that abstinence is the best way to manage the condition. We approach Addiction Treatment from a wellness perspective, working with the mind, body and spirit as being the key components of learning to live a healthy lifestyle.

Meridian Health Services encourages individuals with disabilities, including those in recovery, to apply for positions.

We offer a competitive wage and excellent health and benefit package for full time employees. We provide LIFE, LTD, STD for all full-time employees as well as health, dental and vision insurance that exceed ACA requirements. Generous paid-time off including time for professional development.

As a non-profit organization, our employees are also eligible to participate in the Public Service Loan Forgiveness (PSLF) Program for student loans.'

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Healthcare Credentialing : 2 years (Required)

Work Location: In person