Credentialing Specialist

Description

At Hill Country Mental Health and Developmental Disabilities Center our vision is to empower people, foster hope,
support choice, and celebrate success.

**HILL COUNTRY MHDD CENTERS IS OFFERING A $2,000 SIGN ON BONUS FOR ALL MENTAL HEALTH POSITIONS THAT ARE FULL-TIME, NEW HIRE EMPLOYEES**

“Promoting Independence, Community Integration, and Recovery.”

Help us help others:

The Credentialing Officer will work under direct supervision of the QM/UM Director. The Credentialing Officer is responsible for the following duties: reviewing minimum qualifications on all credentialed positions prior to hiring, providing internal credentialing for all credentialed providers, applying for enrollment in various insurance agencies for all licensed providers, tracking and maintaining running rosters of credentialed providers, and running the credentialing committee meetings. The Credentialing Officer will also be responsible for taking minutes for the QM quarterly meetings when they arrive, maintaining policies and procedures for credentialing, and other duties as assigned.

You will get to:

Internal Credentialing:

• Work closely with the Human Resources Department and to review and approve minimum qualifications of any credentialed new hire positions prior to interviews.
• Ensure all credentialing documentation is completed and submitted to the credentialing officer prior to an employee attending New Employee Orientation
• Keep active files and tracking forms for all credentialed employees in physical and electronic forms.
• Strive for efficient electronic processes.

Enrollment and Credentialing for Insurance:

• Maintain facility credentials for all of Hill Country MHDD Centers
• Work with contract staff and employees to obtain appropriate documentation for enrollment with appropriate organizations.
• Enrolling all licensed providers in appropriate insurance organizations (enrollment in: Medicare, Medicaid, Blue Cross Blue Shield, Amerigroup, Cenpatico, Community First, etc.)
• Maintain and track rosters for all appropriate insurance companies.

Credentialing Committee:

• Organize and hold monthly meetings with all the credentialing committee members.
• Review and provide all documentation for any re-credentialing done during the month along with any initial credentialing.
• Report any negative findings during credentialing process.
• Maintain minutes for the meetings and keep accurate records.

Qualifications

You’ll definitely need:

A bachelor’s degree in business administration, Accounting, or Human Resources
 

Work Experience:

• Minimum of 1 year in a detail-oriented position.
• Minimum 1 year in a credentialing position in healthcare.
• Minimum of 3 years’ Business Administration, Accounting or Human Resources experience.
• Experience working within TMHP and Cactus preferred.

We’ll also want you to:

• Must be proficient in Windows 10 and Microsoft Office.
• Must be detail-oriented in work habits.
• Willing to support team efforts.
• Submit report to Director of QM weekly, and as requested.
• Maintain minutes during quarterly QM/UM Meetings
• Maintain current policies and procedures for the credentialing process.
• Attends work regularly and as scheduled.
• Works cooperatively with others and the Director.
• Communicates effectively and in a timely manner with team and individuals served.
• Follow the agency’s workplace values and principles.
• Maintain client / employee confidentiality and privacy according to standards.
•  Adhere to all Hill Country MHDD policies and procedures.
• Driving a company or personal vehicle as required for service delivery and professional development.

We’re excited to provide:

• PPO health insurance plan, with option to add dependents.
• PPO dental plans and vision insurance options for healthy teeth and eyes.
• Employer paid life insurance.
• 401(a) plan, employer matches your contributions dollar for dollar up to 8% of your salary. You are 100% vested after 3 years of service.
• 457/403(b) plan, employees are immediately eligible to contribute pre-tax earnings.
• Generous paid time off for fun and vacations and paid sick time for when you’re under the weather.
• Authentic and caring environment where folks care about each other.

We can pay you:

$18.26 - $20.19 per hour and benefits plus good karma for doing good in the world.

Salary : $18 - $20