Credentialing Specialist Job at Behavioral Innovations
Overview:
Essential Functions
Why Choose Behavioral Innovations?
Requirements:
Position Summary:
Coordinates, performs a variety of administrative duties required for provider credentialing and enrollment. Interacts extensively with providers, enrollment staff, insurance plans, HR recruitment, clinical departments and leadership to facilitate provider enrollment, and to maximize reimbursement for services rendered.
Duties & Responsibilities
Essential Functions
- Enroll providers with commercial and government payors; and revalidate providers with government and contracted payors.
- Obtain, accurately complete, and submit enrollment applications and related documents to payors.
- Audit payor directories for current and accurate provider information.
- Facilitate payor calls to address contracting and credentialing issues.
- Assure all regulatory requirements are met with commercial payors and state agencies.
- Coordinate enrollment for providers into any out of state Medicaid programs which facilitates reimbursement for BI.
- Prepare all commercial, Medicaid and/or third-party application forms required for credentialing and enrollment purposes for new providers; run reports and manage existing provider accounts for re-credentialing, re-validation and working expirable.
- Familiar with Electronic Medical Records and Billing Systems.
- Perform any other duties assigned
Why Choose Behavioral Innovations?
- Competitive Base Salary
- 15 days PTO + 7 paid holidays
- Medical, Dental, and Vision Benefits options
- Health and Dependent Care FSA (Flexible Spending Account)
- 401K, Voluntary Short-term Disability, Basic Life & ADD, Wellbeing Program
- Company-wide contests and prizes, rewards & recognition
- Good News Thursday - providing shout outs and weekly updates
- Employee Discounts to health clubs, movies, concerts, and more
- Collaborative and Team-Oriented work environment
Requirements:
- Associates degree and three (3) years relevant experience in credentialing or related work experience may be substituted in lieu of educational qualifications.
- 1-3 years of knowledge in a behavioral health or medical clinic setting preferred, but not necessary.
- Exhibit high quality work
- Use excellent judgment
- Communicate clearly
- Take the initiative to identify and resolve issues
- Willing to learn and take on new tasks
- Demonstrate resourcefulness and cooperation
- Exhibit BI’s core values in all interactions
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