Credentialing Specialist

HGA Support Services is seeking a highly organized and detail-oriented Credentialing Specialist to support our growing team of providers and services. This role plays a critical part in ensuring our providers meet all regulatory, payer, and agency compliance standards so we can continue delivering high-quality care to the individuals and families we serve.

If you thrive in a structured, compliance-focused role and take pride in keeping systems accurate and up to date, we’d love to hear from you.

The Credentialing Specialist is responsible for managing the full credentialing lifecycle for licensed and independent providers. This includes initial credentialing, recredentialing (every three years), monthly compliance monitoring, and payer enrollment tracking through systems such as CAQH and the State of Michigan CHAMPS system.

This position works closely with HR, Compliance, Billing, and Leadership to ensure HGA Services remains fully compliant with state, federal, Medicaid, and payer requirements.

Manage initial credentialing and recredentialing processes for psychiatric providers, BCBAs, and other licensed professionals

Conduct primary source verifications for licenses, certifications, education, training, and work history

Maintain and manage provider profiles within CAQH
, including document uploads and required 120-day attestations

Complete and monitor Medicaid enrollment and updates through the CHAMPS system

Submit and track commercial payer enrollments

Track and maintain provider expiration dates (licenses, certifications, liability insurance, etc.)

Conduct required monthly exclusion checks (OIG, SAM, and state databases)

Maintain organized electronic credentialing files

Ensure compliance with Medicaid, payer, and agency policies

Prepare documentation for audits and regulatory reviews

Communicate proactively with providers regarding documentation needs and deadlines

Collaborate with billing to ensure providers are enrolled and billable prior to service delivery

High school diploma required;
Associate’s or Bachelor’s degree preferred

1–3 years of healthcare credentialing experience preferred

Experience with Medicaid enrollment and provider payer portals preferred

Experience using the CHAMPS system strongly preferred

Strong attention to detail and ability to manage multiple deadlines

Excellent organizational and documentation skills

Proficiency in Microsoft Office and database systems

Ability to handle confidential information with discretion

A self-starter who can manage processes independently

Someone comfortable working with compliance standards and documentation requirements

Strong follow-through and deadline management

A team player who supports HGA’s mission and values