Mind Body Optimization
Credentialing & Contracting Specialist
Mind Body Optimization, Colleyville, Texas, United States, 76034
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Credentialing & Contracting Specialist
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Mind Body Optimization .
Position Summary The Credentialing Specialist I plays a vital role in ensuring our clinical team meets regulatory, payer, and organizational standards. This position is responsible for the full lifecycle of provider credentialing and re-credentialing, managing payer enrollments, and maintaining compliance with federal, state, and payer‑specific requirements.
Key Responsibilities
Manage initial credentialing, re‑credentialing, and privileging processes for behavioral health providers.
Coordinate payer enrollment, revalidation, and demographic updates with commercial insurers.
Maintain up‑to‑date provider data in internal credentialing and EHR systems.
Track and ensure timely renewal of licenses, certifications, DEA, malpractice insurance, and other credentials.
Monitor and maintain compliance with NCQA, CMS, and state‑specific standards.
Respond to internal and external credentialing inquiries promptly and professionally.
Collaborate with Human Resources, Clinical Leadership, and Billing/Revenue Cycle teams to ensure smooth onboarding and billing readiness for new hires.
Prepare credentialing files for audits and participate in quality improvement initiatives.
Qualifications
Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred.
2+ years of credentialing experience in a healthcare setting; behavioral health experience highly desirable.
Working knowledge of CAQH, PECOS, NPPES, and payer portals.
Familiarity with state/federal regulations, including Medicaid and Medicare guidelines.
Strong attention to detail and excellent organizational skills.
Proficient in Microsoft Office and credentialing software platforms.
Ability to manage multiple priorities and meet deadlines.
Excellent communication and collaboration skills.
Preferred Qualifications
CPCS or CPMSM certification through NAMSS.
Experience working in a multi‑state behavioral health organization.
Familiarity with EHRs and practice management systems.
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Credentialing & Contracting Specialist
role at
Mind Body Optimization .
Position Summary The Credentialing Specialist I plays a vital role in ensuring our clinical team meets regulatory, payer, and organizational standards. This position is responsible for the full lifecycle of provider credentialing and re-credentialing, managing payer enrollments, and maintaining compliance with federal, state, and payer‑specific requirements.
Key Responsibilities
Manage initial credentialing, re‑credentialing, and privileging processes for behavioral health providers.
Coordinate payer enrollment, revalidation, and demographic updates with commercial insurers.
Maintain up‑to‑date provider data in internal credentialing and EHR systems.
Track and ensure timely renewal of licenses, certifications, DEA, malpractice insurance, and other credentials.
Monitor and maintain compliance with NCQA, CMS, and state‑specific standards.
Respond to internal and external credentialing inquiries promptly and professionally.
Collaborate with Human Resources, Clinical Leadership, and Billing/Revenue Cycle teams to ensure smooth onboarding and billing readiness for new hires.
Prepare credentialing files for audits and participate in quality improvement initiatives.
Qualifications
Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred.
2+ years of credentialing experience in a healthcare setting; behavioral health experience highly desirable.
Working knowledge of CAQH, PECOS, NPPES, and payer portals.
Familiarity with state/federal regulations, including Medicaid and Medicare guidelines.
Strong attention to detail and excellent organizational skills.
Proficient in Microsoft Office and credentialing software platforms.
Ability to manage multiple priorities and meet deadlines.
Excellent communication and collaboration skills.
Preferred Qualifications
CPCS or CPMSM certification through NAMSS.
Experience working in a multi‑state behavioral health organization.
Familiarity with EHRs and practice management systems.
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