Credentialing Liasion provides coordination and completion of credentialing and re-credentialing activities for Behavioral Health Providers. This position is responsible for the review of applications, submission, and maintenance of provider credentialing database and related information.

MINIMUM QUALIFICATIONS: Two (2) years of experience providing administrative support to medical and/or management staff in a healthcare/behavioral health environment, which must include a minimum of one (1) year experience directly related to behavioral staff credentialing. ESSENTIAL FUNCTIONS:

•  Coordinates and facilitates the credentialing process for appointment and reappointment of provider privileges to system practices, facilities and related sites.
• Serves as the point of contact and liaison to providers, operations, regulators and leadership on credentialing matters.
• Reviews credentialing applications for accuracy and completeness to verify provider meets credentialing criteria
• Monitors application progress and submission deadlines for credentialing and recredentialing
• Updates and maintains credentialing database housing provider data and documentation.
• Regularly conducts audits of the database and other related files to ensure current and accurate data.
•  Assists in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to provider credentialing.
•  Responds to external inquiries according to policy and procedure, escalating inquiries as necessary.
• Participates in team meeting.
•   Assists with client inquiries including Facebook group admission, email inbox management, etc
• Maintains copies of current state licenses, certificates, malpractice coverage, and any other required credentialing documents. Tracks expirations to ensure timely renewals.
•   Conducts follow-up to obtain required documentation, resolve identified issues, ensure timely processing, and communicate updates as needed.
•   Other duties or special projects as assigned.

Preferred Qualifications:/p>

• Experience with Dubsado, Credentialing Support Services, CAQH, NPPES and Trello

Supplemental Information: Applicants may be required to pass an extensive background investigation and be fingerprinted.

The Billing Specialist is a critical part of a mental health practice. This team member will support the team by assisting with the following responsibilities:

• Verify benefits and correspond with insurance companies as necessary
• Collect and process client co-pays, coinsurance, and deductibles
• Manage Client Account Receivables
• Manage Insurance Aging Reports
• Generate Client Statements
• Submit & Follow up on EDI Claims
• Post and Reconcile ERA’s
• Investigate and Resolve Denied and Rejected Claims
• Maintain client account (via billing tab, settings and project management system)
• Generate Revenue Reports by clinician
• Track and analyze KPI’s
• Other duties as assigned

Minimum Qualifications

• Energetic, team player
• Values collaboration, innovation and problem solving
• Excellent attention to detail
• Knowledge of mental health insurance billing procedures
• At least two (2) years billing experience (required)
• Ability to work independently with minimal supervision
• Customer service background with strong  communication skills
• Familiarity with TherapyNotes and/or Simple Practice
• Customer service background with strong  communication skills