Medicaid Credentialing Specialist

Job Description

Job Description

Description:

Position Function :  

The Medicaid Specialist provides administrative support to ensure ACH Clinic maintains Medicaid credentialing requirements and supports therapist credentialing processes. This position is responsible for collecting, organizing, tracking, and maintaining documentation required for agency and individual provider credentialing, compliance, and Medicaid-related operational requirements.

Requirements:

Education : High school diploma or equivalent required; associates degree preferred. 

Experience : Experience in in healthcare administration, behavioral health, medical billing, credentialing, or compliance preferred. Strong organizational skills and attention to detail required and ability to manage multiple deadlines and maintain accurate records.

Preferred Requirements :

• Experience with Texas Medicaid requirements.
• Experience with behavioral health provider credentialing.
• Experience with electronic health records or credentialing databases.
• Knowledge of Medicaid requirements, credentialing processes, and provider documentation preferred.

Essential Functions: 

Medicaid Credentialing & Compliance Support: 

• Maintain tracking systems for ACH’s Medicaid credentialing requirements. 
• Monitor credential expiration dates, renewal requirements, and documentation needs. 
• Assist with maintaining compliance documentation required for Medicaid participation. 
• Support audits and credentialing reviews by maintaining accurate records.

Therapist Credentialing Support: 

• Coordinate collection of required documentation from therapists/providers.
• Track individual therapist credentialing status and outstanding requirements.
• Communicate credentialing requirements, deadlines, and action steps to providers.
• Maintain accurate credentialing files and databases.

Administrative Support 

• Assist with Medicaid-related documentation and billing support activities.
• Maintain organized records related to provider enrollment and credentialing.
• Prepare reports and updates related to credentialing status.
• Support ACH Clinic operations through administrative coordination. 

Knowledge, Skills & Abilities 

• Strong attention to detail and accuracy.
• Excellent organizational and follow-up skills.
• Ability to maintain confidential information.
• Strong written and verbal communication skills.
• Ability to work independently and collaboratively.

#ACH1

Requirements:

Education : High school diploma or equivalent required; associates degree preferred. 
Experience : Experience in in healthcare administration, behavioral health, medical billing, credentialing, or compliance preferred. Strong organizational skills and attention to detail required and ability to manage multiple deadlines and maintain accurate records.
Preferred Requirements :

• Experience with Texas Medicaid requirements.
• Experience with behavioral health provider credentialing.
• Experience with electronic health records or credentialing databases.
• Knowledge of Medicaid requirements, credentialing processes, and provider documentation preferred.