Credentialing Coordinator (East Coast/Remote) Job – Brooklyn, NY 2022-7813

Company Overview:

CHE is a premier provider of behavioral health services in 14 states and continues to grow into new markets. CHE has been operating since 1995 and employs over 800 psychology and psychiatry providers to deliver care virtually and in person at various care settings. We deliver a unique programmatic approach to behavioral health services and are focused on quality and compliance for facilities and in our outpatient settings. Backed by a leading private equity investment firm, we are looking for aggressive, talented, ambitious, engaging, innovative, and all-around balanced individual to join our team.

Job Summary:

This hourly position is responsible for entering, processing and maintaining the accuracy and integrity of the credentialing and re-credentialing of Providers in multi-states. Team members must maintain a working knowledge of requirements of Center of Medicaid/Medicare Services (“CMS”), Council for Affordable Quality Healthcare (CAQH), and 3^rd party insurance requirements. This position maintains a high level of confidentiality, attention to detail, and professionalism in order to credential and prepare clinicians for billable services.

Education

High School Graduate required.
Associates or Bachelor’s Degree preferred.

Experience

Minimum of one to two (1-2) years of provider enrollment, payor contracting, billing or credentialing experience required.

Knowledge

Team members must maintain a working knowledge of requirements for Center of Medicaid/Medicare Services (CMS), Council for Affordable Quality Healthcare (CAQH), and 3^rd party insurance requirements.
Working knowledge of HIPAA and medical terminology.
Knowledge of multi- state credentialing requirements for various disciplines including Psychiatrist, Psychologist, Physician Assistant, Nurse Practitioner and other behavioral health professionals preferred.
Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers.

Skills

Skill in establishing and maintaining effective working relationships with other employees, doctors, facilities, insurance companies and regulators.
Skill in adherence to and administering workflow processes in Credentialing and Provider Enrollment Services.
Detail oriented and tolerant of frequent interruptions and distractions.
Effectively communicate in writing and verbally with physicians, insurers, colleagues and staff.
Proficient in Microsoft Office, including Outlook, Word, and Excel.
Ability to recognize, evaluate, solve problems and correct errors.
Ability to work under minimum supervision and demonstrate strong initiative.
Organized and ale to prioritize and schedule work assignments to meet practice timelines.
Other duties as assigned.

Executes and processes credentialing and payor enrollment services for multi-states.
Responsible for all Credentialing and provider enrollment processes related to compliance, regulations and billable services.
Practices adherence to operating policies and procedures for Provider Credentialing.
Understands and remains updated with current credentialing and payor enrollment related regulations and compliance requirements.
Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
Performs other miscellaneous job-related duties as assigned.

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