Credentialing Specialist - Earll

Terros Health•Phoenix, AZ

26d•Onsite

About The Position

Terros Health is pleased to share an exciting and rewarding opportunity for a Credentialing Specialist working at our Earll location (Must Be An Arizona Resident) . Reporting to the Director of Claims and Credentialing, the ideal individual is flexible, compassionate and professional. If you enjoy working with individuals during some of the most vulnerable times of their lives this may be just the opportunity you’ve been seeking. Our role provides foundational support to our company’s work. It starts with contracts which we’ve been awarded, our staff credentialing the providers and ensuring that all our sites are licensed so that they may treat patients. Along with great benefits, continuous training and a welcoming environment, we offer the opportunity for you to grow in your career with Terros Health. Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment. For more than four decades, the heart of everything we do is inspiring change for life. We help people manage addiction and mental illness, provide primary medical care, restore families, support our veterans, and connect individuals to the care they need. HOPE ~ HEALTH ~ HEALING Terros Health made the list!! "Most Admired Companies of 2020, 2022 & 2023" as awarded by AZ Big Media. Leads, coordinates, and monitors the INTERNAL credentialing and privileging processes of obtaining, verifying and assessing the credentials of all licensed and certified practitioners. Conducts thorough background investigation using online systems of NPDB, OIG and appropriate state licensing boards for obtaining real-time primary source verification of practitioner credentials. Identifies issues that require additional investigation and evaluation; validates discrepancies and ensures appropriate follow-up. Completes and submits monthly credentialing reports for credentialing committee approval, and quarterly reports for review by Terros Health Board of Directors. Corresponds directly with practitioners, department heads and management staff as needed regarding credentialing status and issues. Executes credentialing duties in accordance with HRSA FQHC regulations and CARF accreditation. Apply with your resume at www.terroshealth.org

Requirements

High School Diploma/GED
Bachelor’s Degree preferred and at least two years’ experience in credentialing preferably in an integrated managed care environment
Knowledge of basic requirements for contracting, insurance, and credentialing for integrated health services, clinical operations.
Knowledge of general rules and regulations governing federally funded clinical programs.
Care related to Utilization review/quality assurance principles and terminology.
Possess excellent analytical skills.
Ability to process electronic reports.
Proficient in Word and Excel.
Ability to communicate effectively, both orally and in writing.
Informational research skills.
Database management skills including querying, reporting, and document generation.
Ability to make administrative and procedural decisions and judgments.
Ability to communicate and work effectively with professionals at all levels.
This role is a non-driving position.
This position is performed at one location and does not require travel to various Terros Health centers.
May be 18 years of age and with less than two years’ driving experience or no driving experience.
Must pass a TB test, a criminal background check and drug test

Responsibilities

Leads, coordinates, and monitors the INTERNAL credentialing and privileging processes of obtaining, verifying and assessing the credentials of all licensed and certified practitioners.
Conducts thorough background investigation using online systems of NPDB, OIG and appropriate state licensing boards for obtaining real-time primary source verification of practitioner credentials.
Identifies issues that require additional investigation and evaluation; validates discrepancies and ensures appropriate follow-up.
Completes and submits monthly credentialing reports for credentialing committee approval, and quarterly reports for review by Terros Health Board of Directors.
Corresponds directly with practitioners, department heads and management staff as needed regarding credentialing status and issues.
Executes credentialing duties in accordance with HRSA FQHC regulations and CARF accreditation.

Benefits

Multiple medical plans - including a no premium plan for employees and their families
Multiple dental plans - including orthodontia
Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support
4 Weeks of paid time off in the first year
Wellness program
Pet Insurance
Group life and disability insurance
Employee Assistance Program for the Whole Family
Personal and family mental and physical health access
Professional growth & development - including scholarships, clinical supervision, and CEUs
Tuition discounts with GCU and The University of Phoenix
Working Advantage - Employee perks and discounts
Gym memberships
Car rentals
Flights, hotels, movies and more
Bilingual pay differential