Credentialing Associate
3 weeks ago
ABOUT Addiction Recovery Care
At Addiction Recovery Care we incorporate the best practices of clinical drug addiction treatment. We provide addiction recovery that works with a commitment to provide hope and freedom to those suffering from addictions. Our passion is to restore productive lives through a recovery program that establishes emotional health, physical wellness, and spiritual growth. Our dedication is to see transformed lives anchored in strong family relationships, meaningful careers, and social responsibility.
GENERAL: The Credentialing Associate leverages premier quality customer service and industry foresight to facilitate efficiency during the facility and provider credentialing / licensure process. Acts as a point of contact for Addiction Recovery Care, LLC with external stakeholders, especially providers and department Directors to ensure the most efficient and successful payer enrollment of new facilities/providers.
QUALIFICATIONS:
High school graduate or equivalent is required
Bachelors Degree Preferred
35 yearsexperience working with insurance payers, hospital or other healthcare setting withresponsibilities related to credentialing and licensure preferred.
Appropriate State and Federal Clearances
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Completion and submission of facility and provider credentialing / licensure applications as drafted by supervisor.
Monitor and track the facility and provider credentialing / licensures enrollment process and provides consistent and timely follow-up on outstanding issues as well as status reports to management.
Proactively initiate oversight of existing provider and facility record issues / problems with credentialing configuration.
Coordinate, updates communication between provider(s) and appropriate stakeholders that includes follow-up communications, concise issue resolution and the collection and distribution of all necessary documents and forms in a timely manner.
Research and contact providers and other leadership to resolve enrollment application deficiencies.
Utilizes appropriate credentialing databases, optimizing efficiency and performs document generation; Assist in troubleshooting to prevent provider plan participation interruptions.
Identifies potential process improvements and collaborates with all stakeholders to implement effective process improvements
Adheres to policies and procedures including data security and HIPAA requirements
Timely notifies supervisor of any unresolved issues with payers that would / prevent delay occupation of premises or delay in billing / payment.
Review and maintain on a continual basis all bulletins and correspondence from payers for current information.
Make recommendations for improvements in the credentialing / licensure process
Contributes to team effort by accomplishing results.
Other duties as assigned.
Addiction Recovery Care, LLCoffers a competitivebenefits package, including:
Health,Dental and Vision Insurance
Short-Term/Long-TermDisability Insurance
Other ancillary insurance products i.e.,Critical Illness, Accident policies, etc.
Paid Holidays and Vacation
Optional company sponsored retirement savings plan (401k)
Salary market competitive and commensurate with experience.
Addiction Recovery Care, LLC is an equal opportunity employer.
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