Credentialing Specialist (Behavioral)
Posted 12 hours ago
Worldwide
⭐
2-5 years experience
Please mention DailyRemote when applying
AI Summary
The specialist will manage provider enrollment applications and serve as the subject matter expert for credentialing requirements in assigned states. Responsibilities include coordinating with account managers, submitting documentation via portals, and tracking application statuses for timely approvals.
This is a remote position.
Job Highlights:
- Contract type: Independent Contractor
- Night Shift Schedule: Monday to Thursday - 8:45am to 5pm New York Time (8:45pm - 5am Manila Time)
- Friday - 8:45am to 3:45pm New York Time (8:45pm - 3:45am Manila Time)
BHE Provider Enrollment Team Assistant will assist in the submission of provider enrollment applications for assigned states with complex regulations or high provider volume. Serve as the primary subject matter expert for credentialing and enrollment requirements in assigned state(s).
Responsibilities:
- Maintain current knowledge of both in-network and out-of-network enrollment processes.
- Partner with Account Coordinators to validate provider data and documentation prior to initiating enrollment applications.
- Establish and maintain productive working relationships with payor representatives in assigned states to support clear communication and timely issue resolution.
- Prepare and submit provider enrollment documentation through appropriate channels, including payor portals and mailed submissions.
- Track application status and perform proactive followups to drive timely approvals.
- Manage recredentialing submissions and communicate upcoming client requirements to Account Management.
- Complete quarterly and other required payor attestations to ensure ongoing compliance.
- Attend weekly team meetings, completing the to-do’s assigned to team member.
- Update team leader on recurring issues
- Other Duties as Assigned
Requirements
Knowledge/skills/abilities:
- Exceptional attention to detail and strong organizational skills.
- Critical thinking and problem-solving abilities in complex or ambiguous situations.
- Ability to work effectively in a fast-paced, deadline-driven environment.
- Clear and professional verbal and written communication skills.
- Strong reading comprehension and ability to interpret regulatory and procedural guidance.
- Professional yet assertive communication style when working with payors to drive timely outcomes.
Education/experience required:
- At least 2 years in college
- Two years experience in US-based medical billing practice or
- Two years experience in a medical practice dealing with billing including but not limited to, provider credentialing, authorizations, reimbursement, etc. preferably in Behavioral Health to some degree
MBH Core Values: We hire/fire/promote based on these core values + job-specific performance:
- Respectful of our unique cultural environment
- Absolute Confidentiality
- Embracing Teamwork
- Loyal Behavior & Positive Attitude
- Accountability
- Proactiveness
- Thoroughness
- Focused on results
- Inspired to learn & grow constantly
- Devoted to providing top-tier services to our clients through the "Unique Service Oriented Philosophies"
Benefits
Independent Contractor Perks
- Permanent work from home
- Immediate hiring
- Steady freelance job
- Profit sharing incentive
- Paid time off
- Holiday pay
- Annual Performance and Raise Evaluation
- Quarterly Perfect Attendance Incentive
- HMO
- BruntWork Loan Assistance
Please note that since this is a permanent work-from-home position and an “Independent Contractor” arrangement, the candidates must have their own computer and internet connection. They will handle their own benefits and taxes. The professional fees are on hourly rates and the rate depends on your performance in the application process.
ZR_28916_JOB
Automatically Apply to the Best Remote Jobs
Stop the endless job search. Our AI finds and applies to the best jobs for you.
