CREDENTIALING SPECIALIST

Nat-Su Behavioral Health is seeking an experienced Credentialing Specialist. Credentialing Specialists ensure that staff members maintain current credentials and licenses to work legally in their field or specialty. These specialists monitor upcoming renewal dates and work with medical staff to advise them of the required steps to maintain their credentials. The credentialing specialist will function as a liaison between mental health practitioners and insurance carriers nationwide, coordinating all aspects of the credentialing/contracting process on behalf of the clinician. Preparing and maintaining reports of credentialing activities, accreditation, membership, or facility privileges.

Essential Functions:

• Maintain compliance with all regulatory and accrediting institutions.
• Monitor staff credentials and licenses.
• Advise staff on renewal procedures.
• Participate in the development of internal credentialing processes.
• Keep records of licenses, credentials, and insurance contracts.
• Research and compiles insurance specific submission guidelines.
• Enters, updates, and maintains data from clinicians into the credentialing database (CAQH).
• Research and compiles insurance specific submission guidelines.

Knowledge/Skills/Abilities:

• Trust and dependability are necessary.
• Credentialing Experience / Experience performing similar duties in a medical setting.
• Medicaid/Medicare Experience
• Medical Insurance Experience
• Exceptional verbal and written communication skills
• Ability to establish and maintain effective relationships with coworkers and clients.
• Ability to multitask, maintain organization standards, and work on several tasks in unison.
• 1 year minimum experience

Working Conditions

• Work is performed in a typical office setting with a review period to determine if Hybrid Schedule is optimum.
• Willingness to work Overtime as needed.

Job Type: Full-time Hourly

Hourly Rate: DOE

Benefits:

• 401(k)

• 401 (k) Matching

• Medical Insurance

• Dental Insurance

• Vision Insurance

• HSA

• Life Insurance

• Paid Time Off

• Accidental Insurance

• Critical Illness Insurance