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Credentialing, Prior Authorizations,
2 weeks ago
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Full-Time In Person
Welcome to Inspire Horizons
Were a clinician-led pediatric therapy organization committed to supporting children with developmental delays and disabilities. Our approach brings together experts in Occupational Therapy, Speech Therapy, Feeding Therapy, and Applied Behavior Analysis (ABA) to create a collaborative environment where our clients and their families can thrive.
Position Overview
The Intake, Referrals, Authorizations & Credentialing Coordinator is responsible for managing the intake process, referrals, obtaining prior authorizations, and ensuring provider credentialing compliance. This role is essential in facilitating seamless patient access to care and maintaining regulatory and payer compliance.
Compensation
- $27.50 - $32.50
Work Schedule
- Mon. - Fri. 7:00am - 4:00pm (1hr lunch)
Credentialing Responsibilities
- Complete and maintain credentialing and re-credentialing for providers with payers and regulatory agencies.
- Monitor and track provider credentialing status to ensure compliance with deadlines.
- Update and maintain credentialing databases and documentation.
Prior Authorizations
- Obtain prior authorizations for Occupational & Speech therapy from insurance providers.
- Follow up on pending authorizations and resolve any issues or denials.
- Maintain detailed records of authorizations and approvals.
Intake & Referrals
- Receive and process new patient referrals, verifying eligibility and benefits.
- Collect and document necessary patient information in the system.
- Communicate with referring providers, patients, and internal teams to ensure smooth transitions.
Requirements
- 3+ years of experience in credentialing and prior authorizations within a healthcare setting.
- Certified Practitioner Credentialing Specialist (CPCS) preferred but not required.
- Experience in verifying NPIs, Licensures, and use of related portals.
- Advanced management skills with APEP and CAQH.
- Experience with DDD, FOCUS, and HCBS certifications preferred but not required.
- Knowledge of CPT codes, medical terminology, insurance guidelines, and prior authorization requirements.
- Excellent communication and interpersonal skills to interact with providers, payers, and team members.
Benefits
- Health, vision, and dental benefits
- 401K (4% match)
- 8 paid holidays (including 1 floating holiday)
- 10 PTO days
Inspire Horizons is an equal opportunity employer. We welcome applications from individuals of diverse backgrounds, including BIPOC, LatinX, LGBTQ+, and those with disabilities. Accommodations during the application or interview process are available upon request.
Apply now to join Inspire Horizons and make a meaningful impact on children's lives For more information or to apply, please visit the Inspire Horizons Career Page.
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