Credentialing Specialist

Credentialing Specialist

Full Time | Days
Pay starts at $28.28/hour

All Faiths Children’s Advocacy Center (AFCAC) is currently seeking a Credentialing Specialist to join our team and help children and families thrive! AFCAC are the only Children’s Advocacy Center in Albuquerque, working as trusted advocates for children and families affected by trauma.

The ideal candidate will share Our Mission: We are the trusted advocates for children and families affected by trauma.

By joining our team during this pivotal moment, you will:

• Be at the heart of a community-centric approach to mental health.
• Engage in evidence-based interventions, advocating for holistic care and collaboration.
• Play a crucial role in a team that is dedicated to reshaping care and ensuring a lasting, positive imprint on our community’s well-being.

Are you ready to be part of a transformative movement?

Required:

• High school diploma or GED certificate.
• Four (4) years of relevant experience.

Preferred:

• Certified Provider Credentialing Specialist (CPCS) certifications preferred.
• Associates degree in relevant field preferred.

What will I do as a NM Home Study Provider with All Faith’s?

• Create and maintain licensing, credentials and insurance contract records for employees and the agency.
• Verifies employee licensures and/or credentials for new employees and throughout the employees’ lifecycle and/or contractors through the state and/or educational institution(s).
• Confirm the education and work history of employees.
• Complete new, changes, and termination roster updates to all contracted entities (Medicaid, Medicare, MCOs, etc.)
• Keep a database of all employee/provider credentials.
• Maintain provider credentialing records int eh electronic medical records system (EMRBear).
• Establish and track roster timelines for each provider.
• Monitor license and credential expiration dates and advise employees of required “renew by” dates.
• Track and complete re-attestation requirements for CAQH, MCOs, Medicaid and Medicare
• Maintain agency CMS I&A account and NPPES account.
• Partner with employees on establishing and/or updating credentialing information such as CAQH profiles, NPI registration, CMS accounts and account connection requests.
• Track and update training certificates for credentialing purposes
• Ensure the agency and employees are maintaining compliance with regulatory and accrediting institutions.
• Participate in the development of internal credentialing processes.
• Conduct research on updated state and federal regulations and policies for credentialing purposes
• Make recommendations on the internal credentialing processes to maintain compliant agency standards with regulation changes.
• Release information to agencies and members of the public as required by law.
• Process and track executed contracts in partnership with the Credentialing Specialist’s Supervisor (HR) and will work collaboratively with the billing department.
• Facilitate and complete internal audits of credentialing records and compliance.
• Participate in external audits as applicable.
• Assist with new billing and MCO contracts.
• Collaborate with the billing, CQI and clinical team as needed.
• Other duties as assigned.

Knowledge, Skills, and Abilities needed to perform:

• Ability to meet strict deadlines.
• Attention to detail and strong follow through.
• Knowledgeable in policies, laws and procedures.
• Knowledgeable of centennial and commercial marketplaces.
• Strong computer skills and data entry skills.
• Proficiency in database management.
• Critical thinking and problem solving.
• Maintains confidential information.
• Ability to work as a team player.
• Good organizational skills.
• Experience working with behavioral health providers in an office setting or billing office.
• Negotiation skills in navigating contract requirements and credentialing processes.
• Ability to develop collaborative (internal and external) partnerships .
• Works well under pressure.
• Strong research skills.
• Strong verbal and written communication skills to interact with all levels within the agency and external partners.
• Familiarity with medical administration terminology.
• Extensive knowledge of provider credentialing.
• PC proficiency includes Microsoft Office and Excel.
• EMRBear experience is preferred.

All Faiths Children’s Advocacy Center cares for our Staff by offering many competitive and generous benefits and perks including:

• Health, Dental, Vision, Life Insurance
• Flexible Spending (FSA)
• 401(k) retirement plan with employer matched savings
• Employee Assistance Program (EAP)
• PTO, 9 Paid Holidays and 2 Paid Wellness Holidays
• Opportunity to make a positive impact on individuals & the community.

All Faiths Children’s Advocacy Center (AFCAC) is committed to providing an equal opportunity in our employment practices to all qualified applicants and employees, without regard to race, age, national origin, color, religion, gender identity or expression, sex, sexual orientation, pregnancy, ancestry, familial status, citizenship, national origin, physical/mental disability (or perceived disability), serious medical condition, genetic information, veteran status, or any other status protected by law in accordance with applicable state and federal law. All Faiths Children’s Advocacy Center (AFCAC) conforms to the spirit as to the letter of all applicable laws and regulations.

Learn more about us at: www.allfaiths.org

Job Type: Full-time

Pay: From $28.28 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Free parking
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Education:

• High school or equivalent (Required)

Experience:

• credentialing specialist relevant: 4 years (Required)

Ability to Relocate:

• Albuquerque, NM 87110: Relocate before starting work (Required)

Work Location: In person

Salary : $28