Credentialing Specialist

Duties and Responsibilities

• Multistate payer enrollment and re-credentialing

• Maintaining Credentialing software and Payer Portals

• Demonstrates ability to balance competing deadlines with accuracy and professionalism

• Ensure that the company complies with federal and state regulations regarding licensure and certification of all professionals

• Maintain data for all providers and track the expiration of certifications and licenses

• Ensure that company provider/professionals timely update certification or licensing as required

• Understand and adhere to HIPAA policies

• Adhere to Cultivate policies and procedures

• Perform other duties as assigned

Qualifications

• Associate degree or equivalent training

• Minimum of three (3) years of experience

• Credentialing certification is preferred

Knowledge, Skills and Abilities:

• Process driven and detail-oriented

• Excellent organizational and time management skills including the ability to effectively multi-task and prioritize appropriately to deliver timely results

• Highly motivated and energetic during work hours

• Communication skills, both oral and written, that are clear, confident, exhibit leadership, professionalism, empathy, and inspire confidence

• Advanced problem-solving skills and the ability to think ‘big picture’ and execute defined goals and plans

• Ability to work full-time (40 hours/week), including some flexibility regarding schedule changes required to accommodate patient and staff needs

• Basic understanding of technology utilized in the field of ABA, including data collection software, to execute high quality services with the ability to learn and oversee practice management tools

• Experience and competency with Microsoft Office Suite including Word, Excel, PowerPoint, and Outlook email and Calendar

• Ability to successfully complete and pass a Background and Drug Screen

Working/Physical Conditions:

• Ability to bend, kneel, crouch, and stand as well as an ability to lift items up to 25 lbs.

• Endurance to move rapidly from a seated position to a standing position to perform required tasks

• Requires eye-hand coordination and manual dexterity enough to operate office equipment, etc.

• Clerical responsibilities and administrative work require appropriate levels of vision and hearing abilities

• Ability to communicate effectively using a variety of audio and video meeting platforms and electronic devices