Credentialing Specialist
Apply NowLocation:
Southfield, MI, US
Company:
BambooHR provides online human resource software and is focused on simplifying the HR management process for businesses.
Summary:
The Credentialing Specialist will manage the credentialing process for mental health providers while ensuring compliance with industry standards. Applicants must possess relevant certifications and substantial knowledge of medical and insurance terminology.
Requirements:
Hard Skills: Medical terminology, Insurance carrier processes
Credentials: Certified Provider Credentialing Specialist (CPCS), Certified Billing and Coding Specialist (CBCS)
Experience: Proven experience in a mental health office or healthcare setting is preferred.
Job Description:
Job Summary
We are seeking a detail-oriented and organized Credentialing Specialist to join our team at our Southfield, Michigan location. In this role, you will be responsible for managing the credentialing process for mental health providers, ensuring compliance with industry standards and regulations. The ideal candidate will possess a strong understanding of insurance carrier operations, mental health office operations, and medical terminology, allowing them to effectively navigate the credentialing landscape.
Responsibilities
- Conduct thorough verification of credentials for mental health providers.
- Maintain accurate and up-to-date records of provider credentials and documentation.
- Collaborate with various departments to ensure compliance with insurance carrier requirements.
- Review applications for completeness and accuracy, following established standards.
- Communicate with providers regarding the status of their credentialing applications.
- Stay informed about changes in regulations and standards related to credentialing processes.
- Assist in the development and implementation of policies and procedures related to credentialing.
Requirements
- Certified Provider Credentialing Specialist (CPCS)
- Certified Billing and Coding Specialist (CBCS)
- Proven experience in a mental health office or healthcare setting is preferred.
- Strong knowledge of insurance carrier processes and medical terminology.
- Excellent attention to detail and organizational skills.
- Ability to work independently as well as part of a team.
- Proficient in using computer systems and software relevant to credentialing tasks.
- Strong communication skills, both written and verbal, to effectively interact with mental health providers and staff.
Join our dedicated team as a Credentialing Specialist and contribute to ensuring high-quality care through effective provider credentialing practices.
