Job Description

Walker Health Services, a medical billing company providing revenue cycle support to healthcare organizations, is seeking an experienced Credentialing & Enrollment Specialist with strong Virginia FFS/MCO experience, preferably within ARTS (Addiction and Recovery Treatment Services).

This role is responsible for end-to-end facility and provider enrollment and credentialing, with a primary focus on Virginia Medicaid, including ARTS programs, residential treatment facilities, and ORP providers, and secondary exposure to select commercial payers. Medicaid facility enrollment experience is required and is a core function of this role.

The Credentialing & Enrollment Specialist will serve as a key liaison between clients, providers, and payers, ensuring accurate enrollment, timely revalidations, and ongoing compliance with payer, state, and federal requirements.

Key Responsibilities

· Lead facility-level enrollment, credentialing, revalidation, and maintenance with Virginia Medicaid FFS/MCOs, including ARTS programs and residential treatment facilities.

· Manage initial enrollments, revalidations, changes of information, ownership updates, service additions, and terminations.

· Coordinate enrollment sequencing between licensure, Medicaid enrollment, and payer credentialing to avoid reimbursement delays.

· Enroll, credential, and maintain individual providers, with a strong emphasis on ORP providers, including proper linkage to enrolled facilities.

· Manage provider onboarding, offboarding, role changes, and reassignments across Medicaid and commercial payers.

· Track and manage provider recredentialing and revalidation cycles to prevent lapses.

· Obtain and maintain provider authorizations, attestations, and documentation, including CAQH profiles and payer portals.

· Serve as a point of contact for credentialing and enrollment matters.

· Monitor application status, follow up with payers, resolve deficiencies, and escalate issues as needed.

· Maintain strong working relationships with payer representatives; existing payer relationships are preferred.

· Maintain accurate and complete credentialing and enrollment records across Medicaid portals, CAQH, payer systems, and internal tracking tools.

· Ensure all records are audit-ready and updated timely.

· Review payer directories and enrollment listings to ensure accuracy.

· Meet or exceed internal timelines and payer deadlines.

Required Qualifications

· 2–5+ years of credentialing and enrollment experience, with direct Virginia Medicaid experience.

· Demonstrated experience with facility enrollment and ongoing maintenance (not provider-only credentialing).

· Strong knowledge of ORP provider enrollment and maintenance.

· Ability to manage revalidations, changes of information, and compliance-driven updates.

· High attention to detail, strong organizational skills, and ability to manage multiple enrollments simultaneously.

Preferred Qualifications

· Experience working with ARTS programs, behavioral health, SUD, or residential treatment settings.

· Experience with Virginia Medicaid MCOs and select commercial payers.

· Established working relationships with DMAS or payer credentialing departments.

· Experience supporting multiple clients in a billing or third-party services environment.

Experience Required

3-4 years