Credentialing Specialist

2 weeks ago

Fort Myers, United States DNA Comprehensive Therapy Services LLC Full time

Come grow with us Elite DNA Behavioral Health is one of the largest providers of behavioral and mental health services in Florida - and we are expanding quickly We believe in providing high-quality, accessible care to our patients and a supportive environment that allows our team to grow professionally.

Our goal is to hire you - the best talent - to support our mission and allow you to grow with us.

We thrive on a mutual goal of providing excellent care to our patients through our comprehensive care services and collaborative culture. Elite DNA is the pioneer of the care coordination approach to mental health, where all patients are matched with their ideal services and providers prior to receiving direct care. Our team is at the forefront of providing leading-edge therapy services - from psychotherapy to psychiatry - to specialized programs such as psychosocial rehabilitation, EMDR, and group therapy.

Everything we do here at Elite DNA is guided by integrity and compassion for our patients and employees.

When you join the Elite DNA team, you will feel proud to be a part of the group that helps children, adults, and families in our communities live better lives.

Job Summary:

Elite DNA Behavioral Health is seeking to hire a full-time Credentialing Specialist to join and support our team in Fort Myers.

DESCRIPTION:

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by commercial payers, Medicare, and Medicaid.

Requirements

•Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.

•Maintain internal provider grid to ensure all information is accurate.

•Update each provider's CAQH database file timely according to the schedule published by CMS.

•Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance

•Complete revalidation requests issued by government payers

•Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid

•Complete re-credentialing applications for commercial payers

•Credential new providers and re-credential current providers.

•Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing.

•Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.

KNOWLEDGE, SKILLS, AND ABILITIES

•Athena, MD-Staff experience

•2 years credentialing experience preferred

•2 years' experience in a medical practice business office role required

EDUCATION/EXPERIENCE REQUIRED:

•High School Diploma or GED

This position earns competitive compensation plus a full benefits package including medical, dental, vision, and life insurance, annual PTO of 15 days with tenure recognition incentives, one additional paid day for your birthday and Employee Assistance Program. We also offer opportunities for growth, as well as a great team atmosphere that empowers you to take ownership of outcomes in providing quality service and support.

To apply visit www.elitedna.com/careers

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