Credentialing Specialist

2 weeks ago


Franklin, Tennessee, United States Acadia Healthcare Full time

Position Overview:

Currently Seeking: Fully Remote Credentialing Specialist

About Our Organization:

At Acadia Healthcare, we are dedicated to enhancing the lives of those we serve. We are looking for passionate and skilled individuals who share our commitment to establishing a premier organization that exemplifies excellence in the treatment of specialized behavioral health and addiction disorders. As a prominent provider of behavioral healthcare services across the nation, our headquarters is located in Franklin, TN. We value employee contributions and promote teamwork to foster a collaborative service delivery system.

Employee Benefits:

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

Role of the Credentialing Specialist:

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

Key Responsibilities:

  • Request and assess 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 credentialing requests, including the upkeep of credentialing files.
  • Manage various database systems effectively.
  • Facilitate 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:

  • Bachelor's degree preferred.
  • Experience with multi-state payor enrollment is essential, with minimal training required. Familiarity with state Medicaid and Managed Care Organization (MCO) payor enrollment for initial and re-credentialing applications is a plus.
  • Effective communication skills with healthcare providers and payors to gather necessary information for enrollment completion.
  • A minimum of two years of experience in credentialing within a healthcare environment is required. Experience in behavioral health credentialing is advantageous but not mandatory.
  • Knowledge of CredentialingStream/Verity is beneficial but not essential.
  • Strong organizational and analytical abilities, with meticulous attention to detail.
  • Excellent verbal and written communication skills.
  • Capability to prioritize tasks and work independently, as well as collaboratively within a team.
  • Able to multitask and perform well under pressure while meeting weekly objectives.
  • Willingness to assist colleagues and departments as needed to accomplish tasks and contribute to additional projects.

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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