(Remote) Provider Contracting & Credentialing Coordinator

CORE JOB DUTIES

• Ensures that all medical and clinical staff are appropriately credentialed with all payers, and payer requirements
• Aids the credential manager in identifying new hire needs to ensure appropriate credentials are inline with payer needs
• Reviews and prepares payer credentialing applications and recredential application for completeness and accuracy
• Works with providers and credentialing department to ensure required information is available to complete processes
• Works in tandem with ARS Teams (Business Development, Marketing and Finance) to identify opportunities for company growth in terms of managed care contracts
• Evaluates and analyzes contract proposals and works with SVP to negotiate best possible contract rates for ARS
• Direct contact and liaison between payers and ARS facilities as it relates to contracts, addendums, and credentialing needs
• Conduct quality control audits of files and take necessary actions to remediate and prevent future errors
• Prepares reports for internal and external use
• Works with billing department to address non-participation or dis-enrolled providers

Requirements

• Minimum of High School Diploma or Equivalent; Bachelor's Degree Preferred
• Minimum three (3) years' experience in provider or payer contracting and credentialing
• Knowledge of Hospital and/or Behavioral Contracting and Reimbursement
• CAQH requirements and profiles, credentialing and re-credentialing applications for facilities and payer contracting
• Strong Computer Knowledge
• This role requires the employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards
• Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.)
• An "up to date" antivirus software
• Working camera and microphone

Benefits:

• Health, Vision, Dental
• Employer Matched 401(k)
• STD, LTD, and Employer Paid Term Life Policy - up to $50k
• Employer Matched HSA - up to $1500 a year company contribution
• Employee Wellness Program - reduce employee premiums $40/mo
• Free MDLive telehealth benefit
• Paid Time Off - Vacation/Personal/Holiday/Sick
• Employee Referral Bonus