Revenue Eligibility & Credentialing Supervisor

Revenue Eligibility & Credentialing Supervisor

Salary

$76,069.50 - $133,282.50 Annually

Location

Prince William County, VA

Job Type

Full-Time (FT)

Job Number

202610851

Department

COMMUNITY SERVICES

Division

Administrative Services

Opening Date

09/22/2026

Closing Date

10/6/2026 11:59 PM Eastern

GRADE

C43

Hiring Salary

$76,069.50 $104,676.00 Annually

• Description
• Benefits
• Questions

Introduction

Prince William County Community Services is seeking a motivated, experienced individual to join our revenue management team as the Eligibility, Credentialing, and Recovery Supervisor. Community Services is a large, community-based behavioral health organization providing a broad range of services to individuals and families throughout Prince William County.

This position provides operational supervision and subject-matter leadership for revenue eligibility, financial assessments, fee agreements, Medicaid and benefit eligibility, provider credentialing and enrollment, self-pay, debt recovery, and related fiscal activities. The position supervises professional-level staff, assigns and monitors work, ensures compliance with applicable regulations and payer requirements, and supports processes designed to maximize appropriate reimbursement and revenue recovery.

About This Role

The Eligibility, Credentialing, and Recovery Supervisor provides operational supervision and subject-matter leadership for revenue-related administrative functions supporting individuals served by Community Services. This position ensures that individuals are appropriately assessed for financial responsibility and benefit eligibility, that eligible Medicaid and other benefit resources are identified and pursued, that providers are appropriately credentialed and enrolled, and that available revenue and recovery opportunities are effectively managed.

The position provides day-to-day supervision, quality assurance, workload management, staff development, process improvement, and compliance oversight for activities involving revenue eligibility, financial assessments, fee agreements, self-pay, Medicaid and government benefit eligibility, clinical credentialing and provider enrollment, debt setup and determination, debt setoff and collection processes, and ongoing monitoring of client financial and benefit status.

The Supervisor serves as a key liaison among Community Services programs, clinical and administrative staff, fiscal operations, Medicaid and other governmental entities, managed care organizations, credentialing and enrollment systems, collection entities, and other internal and external stakeholders.

Key responsibilities include:

• Supervises revenue eligibility, financial assessments, Medicaid and benefit eligibility, fee agreements, self-pay, credentialing, provider enrollment, and debt recovery operations.
• Ensure compliance with applicable federal, state, local, payer, and agency regulations, policies, and financial requirements.
• Leads revenue maximization and recovery efforts by monitoring client status, identifying changes affecting reimbursement or financial responsibility, addressing missed revenue opportunities, and improving collection and recovery outcomes.
• Oversee Medicaid and benefit eligibility processes, including screening, applications, renewals, ongoing monitoring, and resolution of eligibility issues to maximize appropriate reimbursement.
• Oversee provider credentialing and enrollment to ensure required licenses, certifications, enrollments, and related documentation remain current and compliant and to minimize disruptions or loss of reimbursement.
• Directs debt recovery activities, including review and establishment of eligible debts, referrals for collection and setoff, monitoring recovery activity, and ensuring compliance with applicable laws, regulations, and due-process requirements.
• Analyzes operational, financial, and performance data; conducts quality assurance and reconciliations; identifies trends, discrepancies, risks, and compliance issues; and implements or recommends corrective and process improvements.
• Supervises assigned staff by assigning and prioritizing work, establishing performance expectations, providing training and coaching, evaluating performance, supporting recruitment and professional development, and ensuring continuity of operations.
• Develops and maintains policies, procedures, and workflow standards, and serves as a subject-matter resource for management and staff on eligibility, revenue, credentialing, financial, and debt-recovery matters.
• Coordinates with internal and external stakeholders, including clinical, fiscal, human resources, compliance, Medicaid, managed care organizations, and other governmental or regulatory entities, to resolve complex issues and support effective service delivery and fiscal accountability.

A successful candidate will be an experienced and collaborative supervisor who can effectively lead staff and oversee complex eligibility, credentialing, financial, and recovery functions in a behavioral healthcare environment. They possess strong analytical, organizational, communication, problem-solving, and decision-making skills, along with the ability to interpret regulations, manage competing priorities, and work collaboratively with clinical, administrative, fiscal, governmental, and external stakeholders. Proficiency with Microsoft Office and other computer applications used in performing assigned duties is required.

If you are a collaborative leader passionate about supporting staff, strengthening fiscal accountability, maximizing appropriate benefit resources, and ensuring compliance in a behavioral healthcare environment, we encourage you to apply to join the Prince William County Community Services team.

Minimum Requirements:

• High school diploma or G.E.D.

• 6 years of analytical, paraprofessional, healthcare, behavioral health, eligibility, credentialing, financial, revenue recovery, or related administrative experience.

Preferences:

• Experience supervising healthcare, behavioral health, human services, eligibility, credentialing, reimbursement, and revenue recovery functions.
• Experience with Virginia Medicaid (DMAS), Medicaid Managed Care Organizations (MCOs), Medicare, commercial insurance, and other healthcare benefit programs.
• Experience with provider credentialing and enrollment.
• Experience with financial assessments, fee agreements, self-pay, debt recovery, or debt setoff processes.
• Experience interpreting federal, state, payer, or agency regulations and implementing related policies and procedures.
• Experience in analyzing financial or operational data and developing process improvements.
• Knowledge of Medicaid eligibility and enrollment processes, healthcare reimbursement, financial assessments, fee agreements, self-pay, revenue recovery, and debt collection practices.
• Knowledge of federal and state regulations governing healthcare reimbursement, eligibility, credentialing, privacy, and financial recovery.
• Strong analytical, organizational, problem-solving, and decision-making skills with exceptional attention to detail.
• Excellent communication and interpersonal skills, with the ability to establish collaborative relationships with clinical, administrative, fiscal, governmental, and external stakeholders.
• Proficiency with electronic health records, financial or administrative systems, Microsoft Office applications, and other software utilized in the performance of assigned duties.
• Ability to prioritize competing responsibilities, manage multiple deadlines, interpret regulatory requirements, and lead staff in a fast-paced environment.
• Ability to identify operational and fiscal risks and develop practical solutions that improve compliance, efficiency, and revenue outcomes.

Special Requirements (if applicable):

• Must possess a valid driver's license.
• Must pass DMV record check.
• Must pass TB test.
• Offer of employment is contingent upon the candidate passing a fingerprint-based national criminal history record check.

Child Protective Services Requirements: effective 1999, mandated by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) in accordance with 12VA35-105-400 rules and regulations for DBHDS Licensed Providers and related to the Criminal Registry Checks, a search of the registry of founded complaints of child abuse and neglect will be conducted by the Virginia Department of Social Services.

Work Schedule: The work hours will be Monday through Friday, 8:30 AM - 5:00 PM, with a one-hour lunch. The position is based at the Community Services Sudley North location, 8033 Aston Avenue, Manassas, VA 20109.

Hiring Salary Range: $76,069.50 - $104,676.00 Annually

We also offer great benefits, including:

• Retirement from the Virginia Retirement System (VRS)
• 401a and 457 retirement savings plans
• Paid Annual Leave / Sick Leave / Personal Leave
• Paid Holidays
• Group Medical, Dental, & Vision Health Plans
• Group Life Insurance
• Employee Assistance Program (EAP)
• Career Development Opportunities

Full-time positions with Prince William County Government qualify for Public Service Loan Forgiveness. Click here PSLF for additional information.

NOTE: The above position description is intended to represent only the key areas of responsibilities; specific position assignments will vary depending on the business needs of the department. To view the class description in its entirety, click here for the class description.

Prince William County is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the County will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.

SEE YOURSELF HERE!

Prince William County Government offers medical plans with corresponding pharmacy and basic vision coverage, as well as dental plans and a separate vision plan.

Full-time and part-time Prince William County Government employees are eligible to participate in our plans; however, the level and cost of benefits depends on the classification of the position.

The following positions do not accrue leave and are not eligible for holidays or other fringe benefits:

• Temporary
• Provisional
• Seasonal employees

Click on the link below to explore our plans and rates.

Prince William County Benefit Programs

01

By submitting this application, I understand the following: 1) Only the information provided on my application is used to determine my qualifications; 2) My resume will not substitute for the education, work experience, and required fields on the Prince William County application; 3) Only responses to Supplemental Questions that can be verified in my submitted education and work experience will be credited and 4) If selected, my employment dates will be verified for the past three (3) years (if applicable), with a required reference from my current or most recent employer.

• Yes, I acknowledge and understand the above statement and wish to continue in this process.
• No, I do not wish to proceed any further in this process.

02

Please select your highest level of completed education.

• Masters degree or higher
• Bachelors degree
• Associates degree
• High school diploma/GED
• None of the above

03

This position requires a minimum of six (6) years of analytical, paraprofessional, healthcare, behavioral health, eligibility, credentialing, financial, revenue recovery, or related administrative experience. Please indicate your qualifying experience.

• More than 10 years
• 6-10 years
• 1-5 years
• Less than 1 year

04

How many years of experience do you have supervising staff responsible for eligibility, financial assessment, Medicaid/benefit enrollment, credentialing, reimbursement, revenue recovery, or related administrative functions?

• More than 10 years
• 7-10 years
• 4-6 years
• 1-3 years
• Less than 1 year

05

What is the largest number of employees you have directly supervised?

• 7 or more employees
• 4-6 employees
• 1-3 employees
• I have not directly supervised employees.

06

Eligibility and Financial Responsibility - please select all areas in which you have direct professional experience.

• Financial assessments or ability-to-pay determinations
• Fee assessments or fee agreements
• Medicaid eligibility screening or enrollment
• Medicaid renewals and ongoing eligibility monitoring
• Government benefit eligibility
• Insurance eligibility verification
• Self-pay assessment or account management
• Monitoring changes in client financial or benefit status
• Financial responsibility disputes or appeals
• Identifying missed reimbursement or revenue opportunities
• None of the above

07

Medicaid, Insurance, and Benefit Programs - pleaseselect all programs or payer types with which you have direct professional experience.

• Virginia Medicaid (DMAS)
• Medicaid Managed Care Organizations (MCOs)
• Medicare
• Commercial insurance
• Self-pay
• Other government benefit programs
• None of the above

08

If you selected "Other Government Benefit Programs", please list the systems below.

09

Provider Credentialing and Enrollment - please select all provider credentialing or enrollment activities you have performed or supervised.

• Initial provider credentialing
• Re-credentialing
• License and certification monitoring
• Provider enrollment
• Virginia Medicaid provider enrollment
• Medicaid MCO enrollment
• CAQH
• PECOS
• PRSS
• Provider Express
• Availity
• Monitoring credentialing/enrollment compliance deadlines
• Resolving credentialing or enrollment discrepancies
• None of the above

10

Debt Recovery and Setoff - please select all debt recovery activities with which you have direct professional experience.

• Delinquent account review
• Debt determination or establishment
• Collection referrals
• Payment plans or account resolution
• Collection agency coordination
• Debt recovery monitoring and reporting
• Government debt setoff
• Virginia Department of Taxation debt setoff
• Federal/IRS debt collection or offset processes
• Review or escalation of disputed accounts
• Recovery trend analysis
• None of the above

11

Regulatory and Compliance Experience - please select all areas in which you have professional experience interpreting, applying, monitoring, or ensuring compliance with requirements.

• Virginia Medicaid (DMAS) requirements
• Medicaid MCO requirements
• Medicare requirements
• Federal healthcare or reimbursement regulations
• State healthcare or reimbursement regulations
• Provider credentialing/enrollment requirements
• HIPAA/privacy requirements
• 42 CFR Part 2 requirements
• Financial or revenue-related compliance requirements
• Documentation compliance reviews
• None of the above

12

Data Analysis, Quality Assurance and Reporting - please select all activities you have performed or supervised.

• Eligibility reporting
• Credentialing compliance reporting
• Debt recovery reporting
• Financial or operational reconciliation
• Quality assurance reviews
• Identification and correction of discrepancies
• Audit preparation or response
• Trend analysis
• Risk assessment
• Corrective action monitoring
• None of the above

13

Policy, Process Improvement, and Staff Development - which of the following have you led or significantly contributed to? Please select all that apply.

• Developed or revised operational procedures
• Improved Medicaid or benefit enrollment processes
• Developed or revised credentialing/enrollment procedures
• Improved financial assessment or fee agreement processes
• Improved self-pay or revenue recovery processes
• Developed policies or workflow standards
• Implemented quality assurance processes
• Developed or delivered staff training
• Improved operational efficiency or revenue outcomes
• None of the above

14

Healthcare/Behavioral Health Environment - please select all environments in which you have direct professional experience.

• Community Services Board
• Behavioral Health
• Local Government
• State Government
• Federal Government
• Hospital/Health System
• Physician Practice
• Community Health
• Human Services
• None of the above

15

External Stakeholder Experience - please select all organizations or stakeholder groups with which you have professionally coordinated regarding eligibility, credentialing, reimbursement, financial responsibility, or recovery.

• Virginia Department of Medical Assistance Services (DMAS)
• Medicaid Managed Care Organizations
• Medicare
• Commercial insurance organizations
• Virginia Department of Taxation
• Government benefit agencies
• Collection agencies
• Healthcare providers or credential organizations
• Regulatory or auditing entities
• None of the above

16

Please indicate your professional experience with the following software applications.

• Excel
• Word
• Outlook
• Teams
• Webex
• PowerPoint
• None of the above

Required Question

Employer Prince William County Government

Address 1 County Complex Court

Prince William County, Virginia, 22192

Website https://www.pwcva.gov/department/human-resources/careers