Client & Credentialing Coordinator

Job Title : Client & Credentialing Coordinator

Department: Medical Billing

Position Summary: Provides front-office administrative support while managing insurance prior authorizations and assisting with provider credentialing. This role ensures smooth clinic operations, supports revenue cycle integrity, and maintains compliance with payer and regulatory requirements. Ensure a clean and efficient revenue cycle for all self -pay services related to the Behavioral Health Services programs including collections of past due amounts from individuals.

Agency: New View Alliance is the parent company of Gateway-Longview, Inc. and New Directions Youth & Family Services, Inc. providing both agencies with strategic planning, advocacy, and shared administrative support for Finance, Human Resources, Information Technology, Corporate Integrity, Performance Improvement, and Diversity, Equity, and Inclusion.

NVA is an equal-opportunity employer committed to championing the principles of anti-racism, justice, and equity. We welcome prospective employees from diverse cultures and backgrounds who will uphold our values and contribute to our mission. We aim to have a leadership and workforce that is reflective of the communities we serve.

Compensation

$19.50 - $23.90/hour

* Offers based on education and years of relevant experience

Hours/Schedule

Full-Time, 35 hour work week

Monday - Friday

Position Specific Duties/Responsibilities:

• Manage all aspects of provider credentialing, re-credentialing, and payer enrollment to ensure uninterrupted billing capability. Assist providers with maintaining and attesting CAQH profiles; upload and update required documentation. Maintain audit-ready credentialing files and tracking systems.
• Facilitate NPI applications and updates.
• Monitor licensure, malpractice coverage, certifications, DEA registrations (if applicable), and renewal deadlines for Psychiatric Nurse Practitioners and Clinicians to prevent reimbursement disruption.
• Coordinate with providers to obtain necessary clinical documentation for timely submissions.
• Understand and follow HIPAA
• Ensure accurate registration of patient demographics to billing system and complete insurance verification across assigned programs. Call patients to inform them of their copay and deductible responsibility.
• Verify insurance eligibility 48 hours prior to client's scheduled appointments and inform clinician and client if insurance is inactive. Verify new clients added to the schedule after two days and communicate with clinician.
• Review patient bills for accuracy and completeness and obtain any missing information.
• Produce billing statements for co-pays and co-insurances. Respond to billing inquiries on a daily basis. Work collaboratively with the Medical Billing Supervisor as well as the Clinic Supervisor. Adhere to HIPAA rules at all times.
• Gather data and prepare reports as requested by the Medical Billing Supervisor to include insurance adjustments and writeoffs, final notices and collections, and balance statements.
• Other duties as assigned

Knowledge, Skills, and Abilities

• Knowledge of healthcare credentialing and payer enrollment processes (commercial and Medicaid)
• Knowledge of CAQH profile management and provider data attestation requirements
• Understanding of prior authorization requirements for behavioral health and psychological testing services
• Familiarity with EHR systems and healthcare documentation standards
• Must be very detailed driven, well organized, and have strong analytical skills.
• Able to handle highly confidential information.
• Ability to be flexible and adapt to change.
• Understands and values the importance of the "team" in accomplishing goals.
• Must have computer skills and proficiency in Word, Excel and Google Workspace.
• Ability to multi-task and be detail oriented, ability to work independently and be an enthusiastic team player.
• Must have a high degree of discretion dealing with confidential information

Qualifications

• High School Diploma
• 2 years' experience in medical billing in a healthcare setting, account reconciliation and collections
• Experience with prior authorization and credentialing process
• Experience in behavioral health or Medical setting
• Experience with CAQH, Medicaid enrollment, and commercial payer credentialing

An EEO/AA Agency

We want to emphasize that the preferred qualifications are not required and that we are committed to helping our future colleagues develop these preferred skills. We strongly encourage those who are passionate about fostering a diverse, inclusive and equitable human service organization to apply.