Credentialing Specialist

About the role

Kyo is a leading provider of Applied Behavior Analysis (ABA) therapy, dedicated to empowering children with autism and their families to achieve meaningful outcomes. Since 2005, we have partnered with thousands of families across 11 states, delivering effective, convenient, and child-centric ABA therapy designed around each child's unique strengths, needs and goals. At Kyo, our mission is rooted in a commitment to making every moment count for the children and families we support.

Responsibilities

• Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
• Ensuring compliance with various state, federal and payer requirements
• Responsible for pre-application intake, monitoring, application submission and follow up
• Maintaining an efficient and compliant on-boarding process
• Inputing/Updating provider credential databases CAQH and NPPES
• Ongoing monitoring of clinical staff's credentials to ensure licenses and certifications are current and active
• Working closely with internal departments to exchange provider information and follow up on inconsistencies
• Assisting with other miscellaneous duties in the Revenue and Contracting department

Qualifications

• Bachelor's Degree preferred but not required
• Demonstrated proficiency with productivity software and project management software (Microsoft Office, G Suite, Asana)
• Database management skills including querying, reporting, and document generation
• Ability to work independently and as part of a team
• Ability to work in a fast paced, expanding organization
• Strong knowledge of the credentialing process and accreditation and regulatory standards
• Ability to lead and facilitate processes through influence and collaboration
• Working knowledge of Medical Terminology
• Strong organization and verbal communication skills, attention to details required
• Ability to use independent judgment to manage and impart confidential information
• Demonstrated problem-solving skills and initiative to analyze and disseminate relevant credentialing data across internal company departments
• Ability to make priority determinations without direct supervision
• Preferred: Experience with provider credential databases CAQH, NPPES
• Preferred: Experience with JIRA
• Preferred: Experience with HIPAA and compliance-sensitive environments

Pay

$27.88 - $31.25

Physical Requirements

• Must be able to sit and use a computer for extended periods of time
• Exhibit manual dexterity to regularly use and enter data into a computer/tablet/phone
• Ability to read and interpret documents in the English language such as employee handbooks, training materials and procedure manuals
• No or very limited exposure to physical risk
• No or very limited physical effort required
• Ability to perform data entry, operate standard office equipment e.g. copiers, fax