Credentialing / Reimbursement Specialist

Aliviane•El Paso, TX

19d

About The Position

Aliviane Inc. is seeking a Credentialing / Reimbursement Specialist to submit, track, and respond to credentialing and contracting requests, while also assisting the billing department with specific assignments. The role supports an organization providing substance use and mental health services to the community. The specialist collaborates with management to plan and track facility, group, and individual provider licensure and credentialing. The position also connects with new providers to gather information and facilitate credentialing, monitors staff credentials and licensure, and follows up on applications while providing current status reports. The role requires independent work, prioritization, and meeting deadlines with urgency. Other duties may be assigned, including assistance with billing projects.

Requirements

Associate degree or completion of a technical school program.
Five years of similar work experience.
Excellent verbal and communication skills.
Attention to detail in composing, typing, and proofreading materials, establishing priorities, and meeting deadlines.
Excellent knowledge of applicable payer requirements for different provider types.
Excellent knowledge of PEMS, CAQH, and CMS.
Ability to work independently, set priorities, and meet deadlines with a strong sense of urgency.

Nice To Haves

Certified Provider Credentialing Specialist (CPCS) or similar certification preferred.
Behavioral health experience preferred.

Responsibilities

Collaborate with management to plan and track facility/group and individual provider licensure and credentialing.
Connect with new providers to gather needed information and facilitate completion of credentialing.
Monitor and track staff credentials and licensure.
Follow up on and track the status of applications and provide up-to-date reports.
Assist the billing department with specific assignments and billing projects.
Perform other duties as assigned.