Credentialing Support:

• Maintain and update accurate credentialing data for all providers.
• Collaborate with Human Resources to collect and store state licenses, malpractice liability coverage, and other credentialing documents.
• Ensure all credentialing documentation complies with HIPAA and other regulatory requirements.
• Work closely with the third-party billing company to facilitate the credentialing and recredentialing processes.
• Upload required documentation to the third-party billing portal.
• Follow up to ensure timely submission of all necessary paperwork.
• Conduct credentialing sessions during provider orientations to ensure all required documents are gathered.
• Clearly communicate credentialing requirements to new providers and ensure compliance with all necessary standards.
• Assist with ongoing credentialing and recredentialing for behavioral health providers.
• Stay up to date with current credentialing requirements for health plans and regulatory agencies.

Billing Liaison Backup:

• Cross-train in billing liaison responsibilities to provide backup support as needed.
• Assist with the billing process, ensuring that claims are processed efficiently and accurately.
• Work closely with internal teams and third-party billing companies to resolve billing issues and inquiries.
• Assist with the preparation and submission of claims and documentation to ensure timely reimbursement.

Administrative Support:

• Maintain strict confidentiality of provider data and adhere to HIPAA guidelines and regulations.
• Perform other administrative duties as assigned by management.
  

EXPERIENCE/EDUCATION
• High school diploma or equivalent.
• At least 2 years of credentialing experience or relevant experience in a healthcare or administrative setting.
• Understanding of medical credentialing procedures and standards.
• Knowledge of HIPAA regulations and compliance.
• Familiarity with credentialing processes for behavioral health providers is a plus.
• Experience in billing and administrative support is preferred.

JOB SKILLS
• Strong attention to detail and organizational skills.
• Effective communication skills, with the ability to work collaboratively across multiple departments.
• Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
• High level of confidentiality and discretion in handling sensitive provider and billing data.
• Proficiency with computer systems and Microsoft Office Suite.
• Ability to work independently and as part of a team.