Credentialing Specialist

2 weeks ago


Franklin, Tennessee, United States Acadia Healthcare Full time

Position Overview:

NOW HIRING: FULLY REMOTE CREDENTIALING COORDINATOR

Our Mission:

At Acadia Healthcare, we are dedicated to Leading Care With Light. We seek enthusiastic and skilled individuals who share our commitment to delivering exceptional care to our patients and combating the opioid crisis. Our approach is holistic, addressing the entire disease rather than just a part of it.

About Us:

Acadia Healthcare's Comprehensive Treatment Centers (CTC) division operates over 160 outpatient addiction recovery facilities across the nation, providing care to patients undergoing treatment for opioid use disorder. As the foremost provider of medication-assisted treatment in the country, we serve more than 70,000 patients daily. Our goal is to offer comprehensive care by integrating therapies with safe and effective medications. Our team is at the forefront of the fight against the opioid epidemic.

Benefits Offered:

  • Comprehensive medical, dental, and vision insurance
  • 401(k) retirement plan
  • Paid vacation and sick leave
  • Flexible working hours
  • Unmatched opportunities for professional growth within the industry

Role of the Credentialing Coordinator:

The Credentialing Coordinator is responsible for overseeing the credentialing aspect of the contracting process. This role involves collaborating with facilities to prepare the necessary documentation for initial and re-credentialing application submissions while adhering to deadlines, assisting with Medicaid enrollments, and managing Power of Attorney (POA) documentation. The Coordinator ensures the department's workflow is maintained for accuracy and timely completion of tasks.

Key Responsibilities:

  • Request and evaluate essential credentialing documentation for each provider/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 effectively.
  • 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:

  • Preferred BA/BS degree.
  • Minimum of 2 years of experience in credentialing within a healthcare environment is required.
  • Experience with multi-state payor enrollment is essential, with minimal assistance needed for the role.
  • Experience with state Medicaid and Managed Care Organization (MCO) payor enrollment for initial and re-credentialing applications is required.
  • Effective communication skills with healthcare providers and payors to gather necessary information for enrollment.
  • Experience in behavioral health credentialing is a plus but not mandatory.
  • Familiarity with CredentialingStream/Verity is advantageous but not essential.

Skills Required:

  • Strong organizational and analytical abilities with a keen attention to detail.
  • Excellent 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 performance goals.
  • Comfortable working in a dynamic healthcare setting.
  • Willingness to assist team members and other departments as needed to complete tasks.
  • Open to contributing to additional projects as required.

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



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