Credentialing / Reimbursement Specialist
About The Position
Aliviane Inc. is hiring a full-time 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 the organization’s substance use and mental health treatment services and helps maintain licensure and credentialing for facilities, groups, and individual providers. The specialist collaborates with management and new providers to collect information, facilitate credentialing, monitor credentials and licenses, and track applications through completion. The position requires independent work, prioritization, attention to deadlines, and knowledge of payer requirements and relevant credentialing systems. The employee may also assist with billing projects and perform other assigned duties.
Requirements
- 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.
- Associate degree or completion of a technical school program.
- Five years of similar work experience.
Nice To Haves
- Certified Provider Credentialing Specialist (CPCS) or similar certification.
- Experience in Behavioral Health.
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 application status, and provide up-to-date reports.
- Work independently, set priorities, and meet deadlines with a strong sense of urgency.
- Assist with billing projects and specific billing department assignments.
- Perform other duties as assigned.
Benefits
- Medical, dental, and vision insurance.
- 401(k).
- Generous paid time off.
- Extended illness leave.
- Paid holidays.
- Mental Health Hours.
- Growth and development opportunities.
- Flexible schedule.
- Half-day Friday.
- Company-paid life insurance.
- Company-paid short-term disability.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
