(Remote) Provider Contracting & Credentialing Coordinator

The Recovery Village•Weston, FL

6h•Remote

About The Position

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues. They provide assistance to people with substance abuse issues, addictions, and mental health concerns, with facilities across the U.S. The company's mission is to provide the highest quality of care using evidence-based therapeutic models to help individuals live healthy, happy lives without the burden of substance abuse or mental illness. The Provider Contracting and Credentialing Subject Matter Expert (SME) is responsible for assisting the organization with payer contracting efforts, including provider applications, contract analysis, negotiations, and credentialing of facilities and medical/clinical providers. This position ensures successful collaboration between the contracting and credentialing department and multiple other departments such as Sales/Marketing, Finance, Legal, Compliance, Medical, and Operations.

Requirements

Minimum of High School Diploma or Equivalent
Minimum three (3) years’ experience in provider or payer contracting and credentialing.
Knowledge of Hospital and/or Behavioral Contracting and Reimbursement.
CAQH requirements and profiles, credentialing and re-credentialing applications for facilities and payer contracting.
Strong Computer Knowledge.
Ability to utilize own personal computer, meeting expectations of the company's software and virus security standards.
Windows 11 w/ latest Windows update installed (Chromebooks and Apple computers are not compatible).
An “up to date” antivirus software.
Working camera and microphone.
Must live in the US in EST and reside in the Eastern (ET) or Central Time (CT) Zone.

Nice To Haves

Bachelor’s Degree Preferred.

Responsibilities

Ensures that all medical and clinical staff are appropriately credentialed with all payers, and payer requirements.
Assists the credential manager in identifying new hire needs to ensure appropriate credentials are in line with payer needs.
Reviews and prepares payer credentialing applications and recredential application for completeness and accuracy.
Works with providers and credentialing department to ensure required information is available to complete processes.
Works in tandem with ARS Teams (Business Development, Marketing and Finance) to identify opportunities for company growth in terms of managed care contracts.
Evaluates and analyzes contract proposals and works with SVP to negotiate best possible contract rates for ARS.
Direct contact and liaison between payers and ARS facilities as it relates to contracts, addendums, and credentialing needs.
Conduct quality control audits of files and take necessary actions to remediate and prevent future errors.
Prepare reports for internal and external use.
Works with billing department to address non-participation or dis-enrolled providers.