Lead Credentialing Specialist

Beacon Behavioral Partners is looking for a Lead Credentialing Specialist to join our team. This full-time position has the opportunity to work with our Revenue Cycle Team at the opportunity to work onsite at our corporate office located in Plano, TX. We are a growing network of physician-driven psychiatric practices with over 25 years of management experience within the behavioral health industry. Committed to reducing the barriers and burdens that come with owning private practice, Beacon fully manages administrative responsibilities while allowing practices to maintain clinical autonomy. This approach allows physicians to focus on what they do best - taking care of patients.Beacon Behavioral Partners now guides practices across Louisiana, Arkansas, Mississippi, Florida, Texas and multiple other states across the US. Beacon Behavioral Partners leverage access to an expansive network of over 1000 staff members, including psychiatrists, psychologists, nurse practitioners, mental health therapists and recreational therapists at the forefront of the industry. Its experienced and forward-thinking physician advisory board provides clinicians with a supportive community for building best practices and sharing insights for an enhanced patient experience.RESPONSIBILITIES AND DUTIESResponsible for Compiling and maintaining current and accurate data for all providersResponsible for Data entry and maintaining provider information in online credentialing databases and system (Credential My Doc, CAQH, PECOS, NPPES, and SharePoint)Responsible for primary source verification of State license, DEA, and Board certificationResponsible for completing provider initial and re-credentialing applicationsAudits applications for accuracy and completenessResponsible for revalidation requests issued by all payersResponsible for submitting completed credentialing application and supporting documentation to all requested payersResponsible for monitoring application progress and following up with payers as needed until confirmation of "in network" status has been receivedResponsible for maintaining copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers. As well as tracking all state license, DEA, and board certification expirations for all providers to ensure timely renewalsResponsible for tracking CME and, sending quarterly updates to providersUtilizes strong research skills to gather pertinent information regarding providersAnd all other duties as assignedMaintain billing insurance grid, provider insurance grid, and each physician's spreadsheet up to date on current insurance changes.Maintain practitioner electronic file by keeping all applications/licensures current.Collects and validates documents to ensure accuracy of all credentialing elements.Assists in training and monitoring of credentialing specialists, assign work and review for accuracy.Assist in streamlining credentialing process, onboarding and offboarding for providers and new centers.Escalate any personnel issues to Credentialing SupervisorReport and/or escalate provide enrollment issues to RCM leadership.Qualifications:Bachelor's degree in healthcare administration, business administration, or a related field preferred.Minimum of 3 years of experience in provider enrollment and credentialing.Extensive knowledge of provider enrollment regulations and guidelines, including Medicare, Medicaid, and commercial payer requirements.Strong understanding of credentialing processes and best practices.Experience with various payer enrollment portals and systems.Excellent communication, interpersonal, and organizational skills.Ability to manage multiple projects simultaneously and meet deadlines. Detail-oriented and highly accurate.Strong analytical and problem-solving skills.Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)Certified Provider Credentialing Specialist (CPCS) certification preferred.Only those selected for interviews will be contacted. Pre-employment screenings and verification of credentials (if applicable) is required prior to start date. Beacon uses E-verify to confirm the employment eligibility of all newly hired employees. To learn more about E-verify, including your rights and responsibilities, please visit (is an Equal Opportunity Employer.

Created: 2025-05-06