Healthcare Credentialing Administrator

2 weeks ago

Franklin, Tennessee, United States Acadia Healthcare Full time

Position Overview:

Join Our Team as a Fully Remote Credentialing Specialist

About Us:

At Acadia Healthcare, we are dedicated to Leading Care With Light. Our mission is to provide exceptional quality care to our patients while combating the opioid crisis. We believe in treating the entire disease comprehensively, not just addressing isolated symptoms.

Our Organization:

As a leader in outpatient addiction recovery, Acadia Healthcare's Comprehensive Treatment Centers (CTC) division operates over 160 facilities across the nation, assisting patients in their journey to recovery from opioid use disorder. We are the foremost provider of medication-assisted treatment in the country, caring for more than 70,000 patients each day. Our commitment is to deliver holistic care that integrates effective therapies with safe medications, positioning our team at the forefront of the fight against the opioid epidemic.

Benefits We Offer:

  • Comprehensive medical, dental, and vision insurance
  • 401(k) retirement plan
  • Paid time off for vacation and illness
  • Flexible work hours
  • Unmatched opportunities for professional growth within the industry

Role of the Credentialing Specialist:

The Credentialing Specialist is responsible for overseeing the credentialing aspects of the contract process. This role involves collaborating with facilities to gather necessary documentation for initial and re-credentialing applications, ensuring timely submissions, assisting with Medicaid enrollments, and managing Powers of Attorney (POAs). The Credentialing Specialist will maintain departmental workflows to guarantee accuracy and timely completion of tasks.

Key Responsibilities:

  • Request and evaluate essential credentialing documentation for each provider or clinician.
  • Conduct Primary Source Verification for all critical credentialing documentation.
  • Prepare and submit initial and re-credentialing documents for various payors as required.
  • Monitor and track incoming and outgoing credentialing requests, maintaining organized credentialing files.
  • Manage various database systems efficiently.
  • Prepare and submit state Medicaid and other payor enrollments and re-validations.
  • Collaborate with payers, the Central Billing Offices (CBOs), and Contracting Departments to resolve any disputes.
  • Draft and manage routine correspondence, memoranda, and notifications.
  • Work closely with CBOs and Contracting Departments to enhance process efficiency and develop new workflow tools as necessary.
  • Update and maintain internal documentation.

Qualifications:

Education and Experience:

  • Bachelor's degree preferred.
  • A minimum of 2 years of experience in credentialing within a healthcare environment is required.
  • Experience with multi-state payor enrollment is essential, with minimal training needed for the role.
  • Proficiency in state Medicaid and Managed Care Organization (MCO) payor enrollment for initial and re-credentialing applications is required.
  • Strong communication skills to effectively interact with healthcare providers and payors for necessary information.
  • Experience in behavioral health credentialing is advantageous but not mandatory.
  • Familiarity with CredentialingStream/Verity is a plus, though not required.

Skills:

  • Exceptional organizational and analytical abilities, with a keen attention to detail.
  • Strong verbal and written communication skills.
  • Ability to prioritize tasks and work independently.
  • Capability to collaborate effectively within a team environment.
  • Proficient in multitasking and performing well under pressure.
  • Ability to meet weekly objectives.
  • Comfortable in a dynamic healthcare setting.
  • Willingness to assist colleagues and other departments as needed to achieve goals.
  • Open to contributing to additional projects as required.

We are committed to providing equal employment opportunities to all applicants for employment, regardless of individual characteristics protected by applicable state, federal, and local laws.

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