Credentialing Specialist - [Remote]

Job DetailsJob Location: Arizona Rehab Campus - Phoenix - Phoenix, AZ 85023The Credentialing Specialist is responsible for coordinating and managing provider and facility credentialing, enrollment, recredentialing, and payer participation activities for America’s Rehab Campus (ARC). This position works closely with AHCCCS, commercial insurance carriers, and internal departments to ensure providers and facilities remain compliant, credentialed, and eligible for billing and network participation.  The Credentialing Specialist maintains accurate credentialing records, monitors expiration dates and regulatory requirements, submits applications and updates, and assists with compliance and audit readiness. This role requires strong attention to detail, knowledge of AHCCCS and behavioral health credentialing requirements, and the ability to work independently in a remote environment while managing multiple deadlines and priorities.    DUTIES AND RESPONSIBILITIES  Complete and manage provider credentialing and recredentialing applications with AHCCCS, commercial insurance carriers, and contracted networks  Coordinate facility credentialing, enrollment, and updates for behavioral health programs and locations  Maintain credentialing files and ensure all required documentation remains current and compliant  Monitor expiration dates for licenses, certifications, malpractice insurance, DEA registrations, CAQH attestations, and other required credentials  Submit and track AHCCCS provider enrollment applications, updates, and revalidations  Work with insurance payers regarding contracting, participation status, and credentialing follow-up  Maintain provider records within credentialing databases and internal tracking systems  Verify provider credentials including licenses, education, certifications, NPI numbers, sanctions, exclusions, and background screening requirements  Coordinate with HR, Compliance, Revenue Cycle, and Operations regarding onboarding and credentialing status  Assist with audits, surveys, and compliance requests related to credentialing documentation  Maintain knowledge of AHCCCS requirements, payer standards, and behavioral health credentialing regulations  Communicate credentialing updates and deficiencies to leadership and providers in a timely manner  Ensure credentialing timelines are met to avoid interruptions in billing or payer participation  QualificationsQUALIFICATIONS, CERTIFICATIONS, AND EDUCATION REQUIREMENTS:  High School Diploma or Equivalent required  Minimum of 2 years of credentialing experience required  Experience with AHCCCS provider enrollment and behavioral health credentialing strongly preferred  Knowledge of provider and facility credentialing processes for commercial and government payers  Experience with CAQH, NPPES/NPI Registry, sanction monitoring, and license verification systems  Understanding of healthcare compliance standards and payer requirements  Experience credentialing behavioral health providers and facilities  Familiarity with Joint Commission and AHCCCS compliance requirements  CPCS, CPMSM, or related credentialing certification preferred but not required  Strong attention to detail and organizational skills  Ability to manage multiple deadlines and prioritize workload independently  Strong written and verbal communication skills  Proficient with Microsoft Office, credentialing software, and electronic document management systems  Ability to maintain confidentiality and handle sensitive information appropriately  Minimum two (2) years of experience in behavioral health field preferred  Successful clearance of pre-employment criminal/county/state background check  Successful clearance of pre-employment drug and alcohol testing  Additional Notes:  America’s Rehab Campus’s is an Equal Opportunity Employer, a drug free workplace, and complies with Veteran and ADA regulations as applicable.