Credentialing Specialist
Denova Collaborative Health
Summary
As a Credentialing Specialist at Denova Collaborative Health, you will play a key role in supporting provider readiness, compliance, and operational success by ensuring providers, clinicians, facilities, and payer records are properly credentialed and maintained. This role helps ensure our teams can continue delivering quality, integrated care while meeting payer, licensing, regulatory, and accreditation requirements. This is a non-exempt position reporting to the Credentialing Supervisor.
Job description
What You Will Do
- Prepare, submit, and track credentialing and re-credentialing applications for providers, clinicians, facilities, private payers, managed care organizations, and other applicable entities.
- Support credentialing processes for physicians, nurse practitioners, physician assistants, clinical therapists, and other healthcare professionals.
- Collect, verify, and maintain provider documentation, including licenses, certifications, malpractice coverage, DEA/NPI information, education, training, work history, and other required records.
- Ensure credentialing files are complete, accurate, current, and compliant with federal, state, payer, licensing, and accreditation standards.
- Monitor expiration dates and proactively follow up on renewals for licenses, certifications, payer enrollments, insurance, and other required documentation.
- Maintain accurate credentialing databases, trackers, rosters, and provider records to support reporting, audit readiness, and timely updates.
- Communicate regularly with providers, internal departments, leadership, payers, and external agencies to obtain required information and resolve credentialing or enrollment issues.
- Assist with payer enrollment, provider roster updates, and follow-up needed to support timely billing and provider activation.
- Maintain NHSC-related information and documentation, as applicable.
- Support internal audits, compliance reviews, and process improvement efforts related to credentialing and provider enrollment.
- Other duties as identified or assigned.
What We Need From You
- High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration, business, or a related field preferred.
- At least 1 year of administrative, credentialing, healthcare, compliance, payer enrollment, or related experience required.
- 1–3 years of credentialing, provider enrollment, payer enrollment, or healthcare compliance experience preferred.
- Strong attention to detail and accuracy when reviewing, entering, and maintaining information.
- Excellent written and verbal communication skills with the ability to work professionally with providers, leaders, payers, and internal teams.
- Strong organizational and time management skills with the ability to manage multiple deadlines and follow-up items.
- Ability to work independently while also collaborating with cross-functional teams.
- Proficiency with Microsoft Office products, including Outlook, Word, and Excel.
- Ability to use computers, web-based systems, payer portals, credentialing platforms, and other online tools.
- Knowledge of CAQH, NPI, DEA, payer enrollment, licensing, and credentialing documentation requirements is preferred.
Your Work Schedule
This role is based at our Headquarters location. Monday – Friday, 8:00 AM – 5:00 PM. First 90 Days: Hybrid schedule with onsite presence Tuesdays–Thursdays. After 90 days: Hybrid schedule with required onsite presence on Wednesdays, along with additional onsite days as needed based on performance and business needs.
Requirements
- High school diploma or equivalent required
- At least 1 year of administrative, credentialing, healthcare, compliance, payer enrollment, or related experience required
- Strong attention to detail and accuracy
- Excellent written and verbal communication skills
- Strong organizational and time management skills
- Ability to work independently while also collaborating with cross-functional teams
- Proficiency with Microsoft Office products, including Outlook, Word, and Excel
- Ability to use computers, web-based systems, payer portals, credentialing platforms, and other online tools
Benefits
- Medical, Dental & Vision
- 401(k) Matching
- Long & Short-Term Disability
- Holiday Pay
- Paid Time Off
- Life Insurance
- Employee Wellness Program
- Employee Discounts
Company overview
Denova Collaborative Health is a comprehensive mental healthcare provider specializing in integrated behavioral health services. The organization focuses on delivering patient-centered care through a collaborative approach that combines mental health treatment with primary care coordination. Operating primarily in Arizona, Denova Collaborative Health offers a range of services including psychiatric evaluations, medication management, individual and group therapy, crisis intervention, and substance abuse treatment. The company emphasizes evidence-based practices and utilizes a team-based model where psychiatrists, therapists, case managers, and primary care providers work together to address both mental and physical health needs. Their approach is designed to improve access to mental healthcare while reducing stigma and barriers to treatment. Denova Collaborative Health serves diverse populations including adults, children, adolescents, and families, with particular attention to underserved communities. The organization's mission centers on creating sustainable mental wellness through integrated care models that address the whole person rather than isolated symptoms.