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This role is responsible for implementing credentialing guidelines for clinical and field-based personnel set by Centria Healthcare, Community Mental Health organizations, insurance companies, and other agencies. The Credentialing Specialist organizes, maintains, and verifies files on clinical and field-based staff, ensuring they are compliant and always available and eligible to provide client services. Additionally, they will provide a positive customer service experience to team members, including clinical, field staff and payors, by being the point of contact and assisting them with related inquiries.
Success measures include adherence to Centria policies, flawless execution of tasks, and meeting or exceeding personal qualitative and quantitative key performance indicator (KPI) metrics such as customer satisfaction, meeting targeted credentialing measures for active and on-hold team members and internal and external audits.
The below reflects the essential functions considered necessary for this role and shall not be construed as a detailed description of all work requirements inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of all responsibilities and job duties.
An initial assessment of competency will be completed during the interview period and evaluated on an ongoing basis.
While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a screen.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.
Full Time
Ancillary Healthcare
$41k-51k (estimate)
04/14/2024
05/02/2024
centriahealthcare.com
FARMINGTON HILLS, MI
25 - 50
2009
CHRISTOPHER M WILCOX
$5M - $10M
Ancillary Healthcare
Centria Healthcare was founded in 2009 as a provider of Pediatric Nursing and Catastrophic Injury Care. One of Centrias early pediatric patients required ABA Therapy. Centria rose to the occasion, giving birth to the Autism Services branch of Centria Healthcare in 2010. Centria Autism has become a leading provider of Applied Behavior Analysis (ABA) Therapy to children with autism in the country. After just five years, Centria Autism grew to be the largest ABA Therapy provider in Michigan, helping more than 230 children with autism. Centria Healthcare has since expanded its services to Arizona,... California, Massachusetts, New Jersey, New Mexico, Oregon, Texas and Washington. Today, Centria Autism employs nearly 3,500 full and part-time passionate professionals. Centria Healthcare will continue to improve their efforts through community outreach, continued education and employment growth, Centria strives to serve more children living with Autism. The standard-setting care provided by Centria Autism is validated by industry accreditation from The Joint Commission (JCAHO) and the Behavior Health Centers of Excellence (BHCOE).* *Centria Healthcare is BHCOE accredited in Michigan, New Mexico and Texas. These states were awarded a 1-year accreditation by the BHCOE.
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The job skills required for Credentialing Specialist include Customer Service, Microsoft Office, Data Entry, Attention to Detail, Futures, 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.
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.
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.
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Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
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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.
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Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
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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.
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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.
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Make Use Of Advanced Software For Monitoring.
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Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
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Step 3: View the best colleges and universities for Credentialing Specialist.