Credentialing Specialist

POSITION SUMMARY

Under the supervision of the Manager of Billing & Claims the Credentialing Specialist is responsible for supporting Astra facility and provider credentialing and payer enrollment activities for the organization. This role serves as the primary contact between providers, internal teams, and the external credentialing service to ensure accurate and timely submission of all necessary documentation. The position may expand to include direct credentialing and payer enrollment responsibilities as the organization grows or needs change.

ESSENTIAL FUNCTIONS

Act as Astra's main point of contact between providers, internal departments, and the credentialing service vendor. Collect and verify provider documentation such as licenses, certifications, malpractice insurance, and background checks. Ensure provider CAQH profiles are complete and accurate. Monitor credentialing timelines and follow up with vendors, payers, and providers to avoid delays. Maintain organized digital and physical credentialing files and update internal tracking systems. Communicate status updates to leadership and address provider questions related to credentialing. Prepare, review, and submit facility applications to commercial insurance companies, Medicaid, Medicare, and other payers. Track and follow up on credentialing application statuses until approval is received. Ensure ongoing compliance with accreditation and regulatory standards. Monitor and maintain a database of expiration dates for licenses, insurance, and certifications; send reminders for renewals. Complete and assist with Revenue Cycle Management functions as directed by the Manager of Billing & Claims and CFO. Other duties as assigned Other Duties Complete required trainings Work as part of a team Demonstrate cultural and linguistic competence Approach interactions with individuals served and colleagues with a trauma sensitive lens

POSITION QUALIFICATIONS

Minimum education of high school or equivalent. 1-2 years of experience in health care administration, billing, credentialing, or insurance enrollment. Knowledge of CAQH and basic understanding of credentialing and payer enrollment processes preferred. Strong computer software and communication skills. Ability to work independently with minimal supervision. Proficiency with Excel and Microsoft Office software is expected. Strong written and verbal communication skills are required. Successful completion of Kansas Bureau of Investigation (KBI), Central Registry, and other applicable background investigations and possess a valid Kansas driver's license

KNOWLEDGE/SKILLS/ABILITIES

Effective communication skills (verbal and written) Customer focused (internal and external) Excellent listening skills Accountability Reliability Trust/Integrity Adaptability/Flexibility Time Management Organizational Skills Proficiency in MS Office Suite with ability to learn other software programs as necessary Relationship building Problem Solving Attention to detail and accuracy in work Being collaborative

Other Physical Requirements:

None

SUPERVISORY RESPONSIBILITIES

None

WORK ENVIRONMENT

Minimal risk of exposure to aggressive and/or acting out (verbal and physical) adults, children and youth. Position requires long periods of sitting, continual use of the keyboard and personal computer and/or speaking on the telephone. Ability to perform duties as required in a fast-paced office environment. Astra Mental Health and Recovery is committed to providing equal employment opportunities and reasonable accommodation for qualified individuals with disabilities and for religious practices, in accordance with applicable law and guidance issued by the Equal Employment Opportunity Commission (EEOC). Astra does not discriminate against applicants or employees on the basis of race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age (40 or older), disability, genetic information, veteran status, or any other characteristic protected by law. This commitment applies to all aspects of employment, including recruitment, hiring, promotion, compensation, training, corrective action, and termination.