What are the responsibilities and job description for the Credentialing Specialist position at COMPREHENSIVE HEALTHCARE?
Who is Comprehensive Healthcare?
Comprehensive Healthcare provides innovative behavioral health and integrated healthcare services to clients of all ages. We take pride in our creative and collaborative work environment and in delivering clinically excellent, trauma-informed, recovery-oriented services.
What are we looking for in a Credentialing Specialist?
The Credentialing Specialist has the important role of ensuring that all facilities, clinicians, and medical staff of Comprehensive Healthcare are credentialed with the appropriate managed care organizations to ensure the organization can be reimbursed for each service provided by our staff. Primary responsibilities include completing and submitting credentialing applications, assisting clinical staff with required paperwork, verifying staff credentials, processing fee reimbursements, and ensuring all documents are submitted in a timely manner. This position requires frequent coordination with insurance companies, state agencies, other payers, and Comprehensive employees at all levels, so exceptional communication skills are essential. This work requires the abilities to prioritize multiple projects with conflicting deadlines, stay organized when projects are in various stages of completion, and collaborate effectively with external parties to meet deadlines. Previous experience working with insurance vendors and credentialing is required for this role.
Schedule: Monday - Friday ; 8AM-5PM
Credentialing Specialist duties may include:
- completing, submitting, and monitoring initial credentialing applications and renewals for both individual staff members and each facility
- verifying staff professional credential renewals, processing credential fee reimbursements, and providing notification when staff credentials are expiring
- completing applications & the review process for internal privileging, including querying various databases for supporting documentation and preparing files for leadership committee review
- creating resumes & completing paper applications for clinical staff as needed
- tracking credentialing, licensing, and certification statuses to maintain up-to-date files such that accurate information can be provided to support staff, clinicians, and health plans
Qualifications:
- Associate degree in a business-related field
- One year of work experience in provider credentialing and working with insurance payors
- Certified Provider Credentialing Specialist (CPCS) or similar certification strongly preferred
- Additional work experience in provider credentialing may be considered in lieu of the certification
What Comprehensive Healthcare Can Offer You
Training and Development
- A variety of career opportunities in a wide range of settings with room for mobility and promotion
- Regular training opportunities including support, supervision, and consultation
Innovative Program & Services
- A strong reputation for providing quality, evidence-based services within a collaborative multi-disciplinary team environment
- Innovative, forward-looking leadership that seeks to thrive in an ever-changing healthcare environment
- Joint Commission-accredited organization committed to continuous quality improvement
- Established partnerships with major research universities and other community and healthcare providers to implement cutting-edge treatment programs and services
Excellent Benefits
- Competitive salaries within our communities and industry
- Healthcare coverage for employee and qualified family members
- Generous vacation, paid holiday and sick leave policies
- Access to Employee Assistance Program services
- Agency-funded retirement plan with contributions equal to 5% of compensation
- Additional retirement investment opportunities with a 50% investment match of up to 4% of compensation
- Agency-funded life and disability insurance program
- Tuition reimbursement program to support employees pursuing additional education
- Employer-funded student loan repayment assistance
Who is Comprehensive Healthcare?
Comprehensive Healthcare provides innovative behavioral health and integrated healthcare services to clients of all ages. We take pride in our creative and collaborative work environment and in delivering clinically excellent, trauma-informed, recovery-oriented services.
What are we looking for in a Credentialing Specialist?
The Credentialing Specialist has the important role of ensuring that all facilities, clinicians, and medical staff of Comprehensive Healthcare are credentialed with the appropriate managed care organizations to ensure the organization can be reimbursed for each service provided by our staff. Primary responsibilities include completing and submitting credentialing applications, assisting clinical staff with required paperwork, verifying staff credentials, processing fee reimbursements, and ensuring all documents are submitted in a timely manner. This position requires frequent coordination with insurance companies, state agencies, other payers, and Comprehensive employees at all levels, so exceptional communication skills are essential. This work requires the abilities to prioritize multiple projects with conflicting deadlines, stay organized when projects are in various stages of completion, and collaborate effectively with external parties to meet deadlines. Previous experience working with insurance vendors and credentialing is required for this role.
Credentialing Specialist duties may include:
- completing, submitting, and monitoring initial credentialing applications and renewals for both individual staff members and each facility
- verifying staff professional credential renewals, processing credential fee reimbursements, and providing notification when staff credentials are expiring
- completing applications & the review process for internal privileging, including querying various databases for supporting documentation and preparing files for leadership committee review
- creating resumes & completing paper applications for clinical staff as needed
- tracking credentialing, licensing, and certification statuses to maintain up-to-date files such that accurate information can be provided to support staff, clinicians, and health plans
Qualifications:
- Associate degree in a business-related field
- One year of work experience in provider credentialing and working with insurance payors
- Certified Provider Credentialing Specialist (CPCS) or similar certification strongly preferred
- Additional work experience in provider credentialing may be considered in lieu of the certification
What Comprehensive Healthcare Can Offer You
Training and Development
- A variety of career opportunities in a wide range of settings with room for mobility and promotion
- Regular training opportunities including support, supervision, and consultation
Innovative Program & Services
- A strong reputation for providing quality, evidence-based services within a collaborative multi-disciplinary team environment
- Innovative, forward-looking leadership that seeks to thrive in an ever-changing healthcare environment
- Joint Commission-accredited organization committed to continuous quality improvement
- Established partnerships with major research universities and other community and healthcare providers to implement cutting-edge treatment programs and services
Excellent Benefits
- Competitive salaries within our communities and industry
- Healthcare coverage for employee and qualified family members
- Generous vacation, paid holiday and sick leave policies
- Access to Employee Assistance Program services
- Agency-funded retirement plan with contributions equal to 5% of compensation
- Additional retirement investment opportunities with a 50% investment match of up to 4% of compensation
- Agency-funded life and disability insurance program
- Tuition reimbursement program to support employees pursuing additional education
- Employer-funded student loan repayment assistance
Salary : $23 - $35