Credentialing Specialist

Select how often (in days) to receive an alert: Guided by the teachings of Jesus Christ, Saint Louis Counseling supports healing and improved mental health for families and children of all backgrounds through professional counseling and psychiatric services. Saint Louis Counseling operates eight offices throughout metropolitan St. Louis. In addition, its School Partnership Program (SPP) therapists provide onsite services to students at more than 100 schools as well as children who are homeless living at area shelters.

POSITION SUMMARY

Catholic Charities St. Louis, Saint Louis Counseling, is searching for a mission-driven, part-time Credentialing Specialist to support our clinicians and expand access to quality behavioral health services. This role manages provider credentialing, enrollment, and recredentialing with Medicare, Medicaid, commercial insurance plans, and other third-party payers, helping ensure uninterrupted provider participation, compliance, and reimbursement. The ideal candidate is detail-oriented, organized, and committed to supporting the mission of serving individuals and families throughout our community. This position will work 20 hours a week. Pay for this role starts at $25 per hour. Coordinate provider enrollment, credentialing, recredentialing, and disenrollment activities for Medicare, Medicaid, commercial insurance payers, and other third-party reimbursement programs. Prepare, submit, and track credentialing, recredentialing, payer enrollment, demographic update, and provider maintenance applications through approval and implementation. Maintain accurate and complete provider records, credentialing files, and enrollment documentation within credentialing databases, payer portals, and other designated systems. Monitor and track the status of credentialing applications, payer enrollments, and provider participation to ensure timely completion and uninterrupted network participation. Monitor expiration and renewal dates for licenses, certifications, malpractice insurance, DEA registrations, and other required credentials, obtaining updated documentation as necessary. Research payer requirements, regulatory changes, and enrollment guidelines, communicating updates that may impact provider participation, reimbursement, or compliance. Collaborate with providers, payer representatives, billing staff, and internal stakeholders to resolve credentialing discrepancies, enrollment issues, and participation delays. Verify payer participation status, effective dates, and provider enrollment information to support accurate billing and reimbursement processes. Coordinate the addition of new providers, service locations, and provider changes with applicable payer networks. Prepare credentialing reports, enrollment status updates, and related data for leadership and operational stakeholders. Support internal audits, external reviews, accreditation activities, and compliance initiatives by maintaining complete, accurate, and audit-ready documentation. Perform other related duties as assigned.

KNOWLEDGE & EXPERIENCE REQUIREMENTS

High school diploma or equivalent required; associate's degree preferred. Minimum of 4 years of healthcare credentialing, provider enrollment, medical billing, or related experience preferred. Experience managing provider enrollment, credentialing, and recredentialing processes. Knowledge of Medicare, Medicaid, commercial insurance, and other third-party payer credentialing requirements. Experience using CAQH, NPPES, PECOS, and payer enrollment portals. Experience utilizing credentialing, provider enrollment, practice management, or related healthcare software. Familiarity with behavioral health, counseling, healthcare, or medical practice operations. Saint Louis Counselingdoes not discriminate on the basis of handicapped status in the admission or access to, or treatment or employment in, its federally assisted programs and activities. Saint Louis Counselingis an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, or disability.Pre-Employment ScreeningAll candidates receiving an employment offer must submit a pre-employment screening. The screenings will include criminal background check and other background checks (as needed), Family Care Safety Registration, drug screen, an employment and education or licensure/certification verification. Various positions will require physical examination, Tuberculosis screening and Hepatitis A. All offers are contingent upon successful completion of required screening. Our Mission To bring the healing, help, and hope of Jesus Christ to those in need with a compassionate, caring presence. Supporting healing and improved mental health for individuals and families of all backgrounds through professional counseling and psychiatry services. As a part of the Catholic Charitiesfamily, you’ll have the resources to care for those closest to you. Options include generous parental leave policies, flexible working arrangements, group life insurance, permanent health insurance, and dedicated support to help you find the right child care or elder care. #J-18808-Ljbffr Archdiocese of St. Louis