What are the responsibilities and job description for the Contracting and Credentialing Coordinator position at GOALS for Autism, Inc.?
Job Summary:
The Contracting and Credentialing Manager is responsible for implementing and monitoring the Contracting and Credentialing Department with a variety of work in Operations, Compliance, and Human Resources, Financial Operations. This position is a key management role for the corporate office.
Essential Role and Responsibilities:
- Under general direction, assists in the analysis of the company’s regulatory compliance posture and the development of control recommendations
- Read Contract updates and communicate with stakeholders
- Ensure contract changes are implemented for compliance
- Negotiates contract rate increases
- Ensure EHR is up to date for ease of billing
- Ensures appropriate staff are credentialed in a timely manner
- Handles Credentialing denials in a timely manner
- Assists with the analysis and interpretation of regulatory compliance requirements, particularly as it relates to insurance companies
- Provides administrative support by developing and implementing policies and procedures
- Updates Credentialing and Contracting Manual as needed
Qualifications and Education Requirements:
- Computer Proficient and well versed in MS Office and Google Apps.
- Customer Service skills are essential
- Strong verbal and written communication skills.
- Excellent management and leadership skills.
- Highly detailed-oriented and organized
- High patience level
- Capable of multitasking and handling difficult situations
- Minimum of one year ABA Credentialing experience
Positions Supervised (Direct Reports):
- Clinical Therapists and Supervisors
- Credentialing Assistant
Preferred Education or Training Equivalent to:
- Minimum of one year of experience in management preferred.
Minimum Years of Additional Related Experience:
- One year of related professional experience is preferred.
Special Qualifications (Skills, Abilities, Licenses):
- Sensitive to working with an ethnically, linguistically, culturally, and economically diverse population.
- Strong decision-making skills with the ability to multi-task, self-motivate and function as part of a multi-level team.
- Able to exercise confidentiality and discretion pertaining to the work environment
- Able to appropriately interpret and implement policies, procedures, and regulations
- Able to obtain criminal record clearance through Department of Justice
- Able to obtain a negative Tuberculosis test
- Able to demonstrate effective time management
- Applicable knowledge of all computer applications such as Excel, Word and PowerPoint
Physical Requirements (Approximate Percent per 7.5-hour Workday):
- Ability to work for extended periods at computer workstation (90% )
