Credentialing Coordinator

Overview:

Kolmac Integrated Behavioral Health and Concerted Care Group (CCG) is a leading outpatient treatment provider in the Mid-Atlantic region. We are committed to treating individuals whose lives have been impacted by substance use and mental health disorders. We do this by providing compassionate and evidence-based treatment, aimed at improving the quality of life for those we serve.

We stand behind our commitment to diversity, equity and inclusion, which are the core of our company with our patients and employees. Our leadership team invests to enhance the programs we offer patients to expand access to care and offer flexibility. Patient care is at the heart of everything we do. We want your experience and expertise on our team When you join our team, you are connecting to a committed and caring group of colleagues.

We are currently in search of an experienced Credentialing Coordinator for our Burtonsville, MD location. The Credentialing Specialist at Kolmac Integrated Behavioral Health and all its subsidiaries ("Kolmac" or the "Company) will be required to complete the credentialing, re-credentialing process for providers and payor enrollment processes for facility contracts with insurance companies and other accrediting entities. In addition, they will maintain current data for each provider to ensure timely renewal of credentialing, licensing, and certification.

• Review and process providers' initial applications and supporting documentation to identify possible issues. Follow up with healthcare provider as needed to obtain missing information

• Complete and process payer enrollment applications for healthcare providers for Medicare, commercial, managed care, and other identified plans in the market

• Complete timely follow-up on all payer facility enrollment applications

• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and in credentialing software

• As directed, provide updated demographic information with supporting documents to outside stakeholders, such as commercial managed care plans and contracted billing entities

• Maintain Monthly OIG checks

• Ensure that re-credentialing is completed timely to prevent any lapse in enrollment

• Monitor and maintain current documents (License, DEA, CDS, Exclusions, Board Certifications,)

• Terminating enrollment with government and commercial payers upon resignation or termination of providers

• Complete primary source verification and prepare files for committee review

• Establish and maintain long-term working relationships with payors

• Maintains confidentiality of provider information

• Other Duties Assigned

• Associates Degree or 10+ years of credentialing experience in lieu of education

• Behavioral Health knowledge is a plus

• Excellent verbal and written communication

• Detail Oriented

• Can manage workflow to meet deadlines

• Able to work as part of a team and independently

• Self-motivated to achieve goals

• Outside the box thinkers; and excellent at problem solving

• Enthusiastic about being part of an organization that recognizes your talent

• Ability to maintain consistent contact with healthcare providers and insurance companies to ensure that expectations are clear and requirements are completed in a timely manner

• Experience working with credentialing software

We Offer

• Competitive Compensation
• Full Benefits: Medical/Dental/Vision
• Life Insurance
• 401K
• Tuition Reimbursement
• Paid Professional Development Time
• Student Loan Repayment Program
• Paid Vacation Time
• And More

Kolmac Integrated Behavioral Health has been a leader in Outpatient Treatment since 1973. Patient care is at the heart of what we do. Kolmac Outpatient Recovery and Concerted Care Group (CCG) have merged to provide addiction treatment and behavioral health treatment services for individuals, families, couples, and groups. We serve communities across Maryland, DC, Virginia, Delaware, and Pennsylvania. We are still growing