Contracts & Credentialing Paralegal

Overview We're Hiring: Contracts & Credentialing Paralegal Location: Cherry Hill Employment Type: Exempt, Full-Time Department: Revenue Cycle Salary Range: $69,000-$75,000 We are seeking an experienced and detail-oriented Contracts & Credentialing Paralegal. This position supports Bancroft, which is a human services organization serving children, adults with disabilities and individuals with behavioral health needs. In this role, you are responsible for managing payer and provider enrollment and contracts requirements specific to government and community based funding sources. You will oversee all payor contracting and enrollment, including but not limited to: managed care, Medicaid, Medicare, insurance carriers, school districts and private payors. About Bancroft: For over 140 years, Bancroft has been making a difference in the lives of many. The organization is well known for helping people with disabilities achieve fulfilling lives while improving their function, activity and participation in society. Bancroft’s reputation for excellence is based on its commitment to providing a spectrum of individualized services, treating each person with respect and dignity, and providing services in an encouraging and supportive environment. Responsibilities Contracting: Prepares documentation for all payor applications and contracts, including commercial payor initial and re-credentialing applications, annual government contract renewals (both State and Federal), Medicaid applications and revalidations, MLTSS, other State payors, including but not limited to NJ DDD, NJ DHS, NJ CSOC, PA DDD, PA DHS, PA Medicaid, DE DDD, IL DDD, school districts, private payors. Maintains file of required reference documents and obtains updated versions from source departments as needed; protects confidentiality of same. Maintains inventory of all contracts and fee agreements; updates and manages payor contracts in Contract Lifecycle Management (“CLM”) database in Workday. Prepares, maintains, and updates contract summaries. Maintains contracting calendar, scheduling renewals, re-contracting, etc. Prepares contract summaries with key terms for presentation to and review by senior leadership for use for new and renewal contracts. Maintains record of all organizational Medicaid provider numbers and NPI numbers. Prepares and revalidates new group home applications, including NPI numbers. Reports diversity data quarterly or more frequently, if required, to payors and governmental entities. Other duties as assigned. Credentialing: Leads organizational and individual provider credentialing to ensure participation, including Medicare, Medicaid, managed care insurance providers. Establishes CAQH accounts for onboarding clinical providers and completes all CAQH applications. Maintains database of all credentialed providers with relevant supporting documentation. Researches and resolves any credentialing issues; manages deactivation of provider numbers. Maintains and verifies demographic information. Privileging: Leads the process for practitioner applications, including accompanying documents, to ensure applicant eligibility. Processes requests for privileges, ensuring compliance. Prepares credential files for presentation to Clinical Executive Group. Monitors the initial, reappointment and expiration process for all employed clinical providers, ensuring compliance with regulatory bodies. Qualifications Education & Experience: Paralegal certificate or Associates in Paralegal Studies required, Bachelor’s degree preferred. At least 3+ years of experience directly related to a hospital, physician group, managed care or outpatient practice credentialing. Preference given to National Association Medical Staff Services (NAMSS) certification as a Certified Medical Services Manager (CPMSMS) or Certified Provider Credentials Specialist (CPCS). Special Skills: Demonstrated ability to effectively communicate both written and verbally required. Ability to think and work independently, meet deadlines and ensure that assigned projects are completed in a timely and efficient manner. Effective interpersonal skills. Working knowledge of Microsoft Office suite. Valid driver’s license required in incumbent’s name. EEO Statement Bancroft stands strong against racism and hate of all kinds and supports actions leading to respect, equality, fairness and peace. We advocate for and embrace an inclusive and just world. One world. For everyone. We work with heart, respect and collaboration. We are communicators, listeners, problem solvers, partners and collaborators. Bring your authentic self to our team. Bancroft is an Equal Opportunity Employer, and supports diversity, equity and inclusion in its hiring and employment practices, so that every team member can feel a true sense of belonging, and maximize their unique potential. To this end, all applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, veteran status or any other characteristic protected by law. #J-18808-Ljbffr