Credentialing Specialist at None

Benefits include: 

• Family medical, dental, long-term disability, 403(b) plan with 6% match, and more. 
• Generous paid time off policy.  (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual).  Plus, 11 paid holidays annually. 

Schedule: Generally - Monday-Friday 8AM-5PM – schedule can be flexible with hybrid schedules available. 

Overview

The Credentialing Specialist performs credentialing duties focusing on certified staff such as, Qualified Mental Health Professionals (QMHP) and Qualified Mental Health Associates (QMHA), Peer Support Specialists, and Behavior Analysis Interventionists (BAI) ensuring they meet and maintain the required qualifications, certifications and regulatory standards. Assists certified staff with registering and maintaining certification with applicable entities, and tracks recertification timelines. Works closely with providers, various internal departments, insurance companies, State agencies, and other outside agencies to complete the credentialing process.  Must be able to work independently and adjust to changing priorities, organizing workload to complement the needs and deadlines of the organization and maintaining strictest confidentiality.

Responsibilities

Works with sensitive and confidential information, strictly adhering to confidentiality policies of organization.

Coordinates with staff and outside agencies to obtain necessary information to perform the credentialing process.

Prepares and tracks credentialing processes for certification with state registries, licensure, Medicaid provider enrollment, and third party credentialing, as required. Tracks expiration dates and follows up with staff as required. May assist with Medicare provider enrollment.

Assists certified staff, with registration/certification applications and submits them to the appropriate state agencies. Tracks registration/certification processes and communicates with state agencies regarding progress and follow-up.

Enrolls agency staff in electronic training system, troubleshoots staff log in and access issues, and provides, and answers questions regarding, transcripts.

Develops and maintains provider enrollment materials and processes. Assists providers with completion of applications and credentialing paperwork.

Actively develops and carries out communication processes that ensure that supervisor, managers, COO and QA are kept updated as to progress in credentialing, background checks, registry status and other critical areas that impact on agency performance and compliance.

Works closely with the Medical Billing Department and CCO’s to ensure credentialing information/data is accurate for billing and reporting purposes, researches issues, and makes adjustments as necessary.

Organizes and maintains credentialing records.

Performs National Provider Data Bank Queries and Primary Source Verification (PSV) of licensure and education, and participates in other compliance screening.

Qualifications

Combination of education and experience to provide the skills and abilities needed to perform the essential functions of the position.

Possess flexibility to address changing priorities and projects within a fast-paced environment.

Strong attention to detail and outstanding organization skills

Experience with healthcare credentialing preferred.

Candidates must be able to use e-mail, compose documents, save and locate documents electronically, and learn to use our Electronic Health Record (EHR) system. Proficiency in Word and other MS Office applications required.

Must pass state-required background and DMV checks. Candidate must be able to work independently and flexibly, under general supervision.

Options for Southern Oregon recognizes that in order to best serve the healthcare needs of our communities and fulfill our mission, we must learn, grow, incorporate, and value the principles of diversity, equity, and inclusion in our work and in our lives.  We are committed to the continued development of an aware, diverse, and culturally responsive workforce and an organizational culture that is supportive and affirming for all staff and clients.  Options acknowledges that incorporating EDI principles in our practices is an ongoing learning process and we are committed to using our voice to effect positive change.  We recognize that making an impact on health inequities in our community will take more than just a statement and, to this end, our goals, planning, and actions aim to promote and develop equitable and effective health care services to reflect the needs of our diverse communities.

Options for Southern Oregon provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.