About the position
The Credentialing Assistant at the Counseling Center of West Michigan (CCWM) plays a crucial role in supporting the mental health practice by ensuring that provider and directory data is accurately maintained and updated. This part-time position, requiring 16 hours per week, is designed for individuals who are detail-oriented and possess strong organizational skills. The Credentialing Assistant will be responsible for submitting applications for insurance enrollments, managing directory data, and ensuring compliance with various regulations, including the Consolidated Appropriations Act (CAA). The role is pivotal in maintaining the integrity of provider information across multiple platforms, which is essential for the smooth operation of the practice and the quality of care provided to clients. In this position, the Credentialing Assistant will engage in a variety of tasks, including updating CCWM and provider information on platforms such as Availity and insurance websites, as well as third-party administrators like Better Doctor. The assistant will also be responsible for submitting applications for insurance providers, verifying participation status, and reconciling data to prevent billing issues. This role requires effective communication skills, particularly when following up with insurance carriers to check the status of applications and address any challenges that may arise. The Credentialing Assistant will work closely with the team to ensure that all processes are followed accurately and efficiently, contributing to the overall success of the practice.
Responsibilities
- Update CCWM and provider information on various platforms, including Availity and insurance websites.
- Submit Blue Cross Complete and Cofinity applications for eligible providers.
- Verify provider participation status with Aetna and BCBS prior to application submission.
- Cross-reference Provider Participation Sheets (PPS) with the Credentialing spreadsheet to identify discrepancies.
- Manage the process of un-paneling terminated providers from all credentialed plans.
- Conduct follow-up calls with insurance carriers to check the status of applications.
Requirements
- Strong attention to detail and accuracy.
- Ability to work independently and manage multiple tasks effectively.
- Familiarity with credentialing processes, insurance applications, and data management systems.
- Experience with platforms like Availity and third-party credentialing sites is preferred.
- Excellent communication skills, particularly in handling follow-ups with insurance carriers.
Nice-to-haves
- Experience in a medical office setting for at least 1 year.
- Familiarity with medical terminology.
Benefits
- Flexible work schedule with potential for future full-time hours.
- Opportunity to grow within a dynamic team dedicated to improving community mental health.
- A collaborative environment where your role makes a direct impact on the quality of care provided.
