Credentialing Specialist

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-5PMCredentialing Specialist duties may include:completing, submitting, and monitoring initial credentialing applications and renewals for both individual staff members and each facilityverifying staff professional credential renewals, processing credential fee reimbursements, and providing notification when staff credentials are expiringcompleting applications & the review process for internal privileging, including querying various databases for supporting documentation and preparing files for leadership committee reviewcreating resumes & completing paper applications for clinical staff as neededtracking credentialing, licensing, and certification statuses to maintain up-to-date files such that accurate information can be provided to support staff, clinicians, and health plansQualifications:Associate degree in a business-related fieldOne year of work experience in provider credentialing and working with insurance payorsCertified Provider Credentialing Specialist (CPCS) or similar certification strongly preferredAdditional work experience in provider credentialing may be considered in lieu of the certificationWhat Comprehensive Healthcare Can Offer YouTraining and DevelopmentA variety of career opportunities in a wide range of settings with room for mobility and promotionRegular training opportunities including support, supervision, and consultationInnovative Program & ServicesA strong reputation for providing quality, evidence-based services within a collaborative multi-disciplinary team environmentInnovative, forward-looking leadership that seeks to thrive in an ever-changing healthcare environmentJoint Commission-accredited organization committed to continuous quality improvementEstablished partnerships with major research universities and other community and healthcare providers to implement cutting-edge treatment programs and servicesExcellent BenefitsCompetitive salaries within our communities and industryHealthcare coverage for employee and qualified family membersGenerous vacation, paid holiday and sick leave policiesAccess to Employee Assistance Program servicesAgency-funded retirement plan with contributions equal to 5% of compensationAdditional retirement investment opportunities with a 50% investment match of up to 4% of compensationAgency-funded life and disability insurance programTuition reimbursement program to support employees pursuing additional educationEmployer-funded student loan repayment assistanceWho 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 facilityverifying staff professional credential renewals, processing credential fee reimbursements, and providing notification when staff credentials are expiringcompleting applications & the review process for internal privileging, including querying various databases for supporting documentation and preparing files for leadership committee reviewcreating resumes & completing paper applications for clinical staff as neededtracking credentialing, licensing, and certification statuses to maintain up-to-date files such that accurate information can be provided to support staff, clinicians, and health plansQualifications:Associate degree in a business-related fieldOne year of work experience in provider credentialing and working with insurance payorsCertified Provider Credentialing Specialist (CPCS) or similar certification strongly preferredAdditional work experience in provider credentialing may be considered in lieu of the certificationWhat Comprehensive Healthcare Can Offer YouTraining and DevelopmentA variety of career opportunities in a wide range of settings with room for mobility and promotionRegular training opportunities including support, supervision, and consultationInnovative Program & ServicesA strong reputation for providing quality, evidence-based services within a collaborative multi-disciplinary team environmentInnovative, forward-looking leadership that seeks to thrive in an ever-changing healthcare environmentJoint Commission-accredited organization committed to continuous quality improvementEstablished partnerships with major research universities and other community and healthcare providers to implement cutting-edge treatment programs and servicesExcellent BenefitsCompetitive salaries within our communities and industryHealthcare coverage for employee and qualified family membersGenerous vacation, paid holiday and sick leave policiesAccess to Employee Assistance Program servicesAgency-funded retirement plan with contributions equal to 5% of compensationAdditional retirement investment opportunities with a 50% investment match of up to 4% of compensationAgency-funded life and disability insurance programTuition reimbursement program to support employees pursuing additional educationEmployer-funded student loan repayment assistance #J-18808-Ljbffr Comprehensive Healthcare