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Credentialing Specialist
Terros Phoenix, AZ
$63k-83k (estimate)
Other 2 Months Ago
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Terros is Hiring a Credentialing Specialist Near Phoenix, AZ

Overview

Terros Health is pleased to share an exciting and rewarding opportunity for a Credentialing Specialistworking at our Central Avenue Location (possibility for remote work in Arizona is an option). Reporting to the Director of Payer Relations, the ideal individual is flexible, compassionate and professional. If you enjoy working with individuals during some of the most vulnerable times of their lives this may be just the opportunity you’ve been seeking.

We are a healthcare company focused on the whole person, providing primary care and specializing in mental health and substance use treatment for the last 50 years.

We help people live their lives in recovery and we save lives every day. 

Our role provides foundational support to our company’s work. It starts with contracts which we’ve been awarded, our staff credentialing the providers and ensuring that all our sites are licensed so that they may treat patients. Along with great benefits, continuous training and a welcoming environment, we offer the opportunity for you to grow in your career with Terros Health.

Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment. For more than four decades, the heart of everything we do is inspiring change for life. We help people manage addiction and mental illness, provide primary medical care, restore families, support our veterans, and connect individuals to the care they need.

Recently awarded among Arizona’s Most Admired Companies in 2020

Responsibilities

Terros Health is hiring a Credentialing Specialist at our Central Avenue location in Phoenix, AZ. 

***May Work Remote Full or Part Time - In Arizona***

Bachelor’s Degree Preferred

Two Years’ Experience in Credentialing (Preferably in an Integrated Care Environment)

Possess Excellent Analytical Skills

Strong Interpersonal Skills 

Full-Time, Employed

Monday-Friday, 8am-5pm

No Weekends

No Call

Offering Excellent Salary

Full Benefits, Including 401K and Generous PTO/PST (4 weeks)

Credentialing Specialist Duties Include:

  • Leads, coordinates, and monitors the INTERNAL credentialing and privileging processes of obtaining, verifying and assessing the credentials of all licensed and certified practitioners.
  • Conducts thorough background investigation using online systems of NPDB, OIG and appropriate state licensing boards for obtaining real-time primary source verification of practitioner credentials.
  • Identifies issues that require additional investigation and evaluation; validates discrepancies and ensures appropriate follow-up.
  • Completes and submits monthly credentialing reports for credentialing committee approval, and quarterly reports for review by Terros Health Board of Directors.
  • Corresponds directly with practitioners, department heads and management staff as needed regarding credentialing status and issues.
  • Executes credentialing duties in accordance with HRSA FQHC regulations and CARF accreditation.

Terros Health offers an excellent benefit package including, but not limited to:

  • Medical, dental, and vision insurance
  • Group life and disability insurance
  • Employer matched 401(k)
  • Generous PTO/paid sick leave (4 weeks in year 1)
  • Wellness and employee assistance plan

Apply with your resume at www.terroshealth.org 

Qualifications

  • Bachelor’s Degree preferred and at least two years’ experience in credentialing preferably in an integrated managed care environment
  • Knowledge of basic requirements for contracting, insurance, and credentialing for integrated health services, clinical operations.
  • Knowledge of general rules and regulations governing federally funded clinical programs. Care related to Utilization review/quality assurance principles and terminology.
  • Possess excellent analytical skills.
  • Ability to process electronic reports.
  • Proficient in Word and Excel.

Knowledge, Skills and Abilities Required

  • Ability to communicate effectively, both orally and in writing.
  • Informational research skills.
  • Database management skills including querying, reporting, and document generation.
  • Ability to make administrative and procedural decisions and judgments.
  • Ability to communicate and work effectively with professionals at all levels.
  • This role is a non-driving position. This position is performed at one location and does not require travel to various Terros Health centers. May be 18 years of age and with less than two years’ driving experience or no driving experience.
  • Must have a valid Arizona Fingerprint Clearance card or apply for an Arizona fingerprint clearance card (Level 1) within 7 working days of assuming role.
  • Must pass a TB Test.

Physical demands of this position are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

COVID 19 Precautions:

Terros Health remains open for all our patients’ health and wellness needs. We have put in place many protocols to protect our employees and patients and to create a safe work environment. Visit our website to learn more: https://www.terroshealth.org/covid-19/

Job Summary

JOB TYPE

Other

SALARY

$63k-83k (estimate)

POST DATE

01/19/2023

EXPIRATION DATE

04/03/2023

WEBSITE

terros.com

HEADQUARTERS

Phoenix, AZ

SIZE

<25

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The job skills required for Credentialing Specialist include Managed Care, Mental Health, Communicates Effectively, Integrity, Quality Assurance, 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.

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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.

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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.

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