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Credentialing Specialist
$61k-80k (estimate)
Other | Energy 2 Months Ago
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ANY BABY CAN OF AUSTIN INC is Hiring a Credentialing Specialist Near Austin, TX

Job Details

Level: Experienced
Job Location: Main Office - Sheridan - Austin, TX
Position Type: Full Time
Education Level: High School
Salary Range: $20.00 - $22.00 Hourly
Job Shift: Day
Job Category: Finance

Who We Are?

Any Baby Can is proud to be recognized as one of the Best Places for Working Parents in Austin. We’re a nonprofit organization focused on empowering families to achieve the best possible outcomes for their children.

At Any Baby Can, we recognize our staff as the most valued resources and the drivers of our success. We prioritize staff well-being in a variety of ways, including a competitive benefits package and perks such as flexible and remote work hours, 19 paid holidays (including up to 10 days of paid time off between the winter holiday and New Year’s!), up to 96 hours of accrued personal time off, and 80 hours of accrued vacation time during the first year of full-time employment.

Position Summary:

The Credentialing Specialist plays a critical role in the revenue cycle by coordinating all aspects of the credentialing and re-credentialing process for all providers rendering services at Any Baby Can. This position ensures providers are credentialed appropriately and timely and ensures ongoing maintenance of provider information to maintain compliance with internal and external policies and regulations. This position is also responsible for obtaining all required prescriptions and pre-authorizations prior to service delivery and submission of claims. This position regularly interacts with Any Baby Can providers, staff, and various external parties to ensure all critical aspects of the role are accomplished timely and accurately.

Key Responsibilities:

  • Completes provider credentialing and re-credentialing applications; monitors status of applications and follows-up as needed.
  • Tracks state license expirations for all providers to ensure timely renewals.
  • Maintains accurate provider profiles on CAQH, NPPES, CMS and all payer databases.
  • Work closely with Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing.
  • Assists with preparing provider files and materials for internal and external audits.
  • Obtains pre-authorizations for certain procedures.
  • Works closely with physicians to obtain signed prescriptions for therapy services.
  • Other assignments may be added as needed or required.


Experience and Qualifications:

  • High-School diploma or equivalent.
  • Two years of relevant credentialing experience.
  • Nonprofit and/or experience with the Early Childhood Intervention program is a plus.
  • Bachelor’s or Associate degree with a major in a related field may substitute for required experience.
  • Certified Provider Credentialing Specialist (CPCS), preferred.
  • Proficiency with Microsoft Office, including Word, Excel, and Outlook. Experience working with medical billing software (RXNT) a plus.
  • Demonstrated experience communicating effectively with internal and external partners to achieve goals and meet deadlines.
  • Ability to handle and preserve confidential and sensitive information and follow HIPAA guidelines.
  • Capable of working both independently and as a member of a collaborative team, as well as communicating with individuals at all levels of the agency.
  • Skilled in meeting deadlines and managing time and resources, in addition to demonstrating pro-active, problem-solving skills.

Special Considerations:

  • Ability to sit for extended periods of time.
  • Ability to communicate effectively/clearly.

Job Summary

JOB TYPE

Other

INDUSTRY

Energy

SALARY

$61k-80k (estimate)

POST DATE

01/21/2023

EXPIRATION DATE

02/07/2023

WEBSITE

abcaus.org

HEADQUARTERS

Austin, TX

SIZE

25 - 50

INDUSTRY

Energy

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The job skills required for Credentialing Specialist include Billing, Microsoft Office, Problem Solving, Communicates Effectively, HIPAA, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.

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If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Credentialing Specialist job description and responsibilities

A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.

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A credentialing specialist can have certificates that will prove useful to their field.

02/01/2022: Newark, NJ

Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.

02/21/2022: Evansville, IN

Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.

02/01/2022: Las Cruces, NM

Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.

01/18/2022: Pueblo, CO

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Credentialing Specialist jobs

Credentialing specialists can often find work with a high school diploma or the equivalent.

01/25/2022: Kingsport, TN

Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.

03/01/2022: Parkersburg, WV

While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.

12/25/2021: Little Rock, AR

Make Use Of Advanced Software For Monitoring.

01/18/2022: New London, CT

Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.

01/31/2022: Portsmouth, OH

Step 3: View the best colleges and universities for Credentialing Specialist.

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