Credentialing Specialist

Maternal and Family Health Services’ programs touch the lives of over 90,000 people each year and empower individuals and families of diverse backgrounds to lead healthier lives. Our mission of empowerment, inclusion, and caring extends to our valued staff as well. We are better together because of our diversity, recognition of differences as strengths, and commitment to providing a culture of acceptance internally as well as to the people we serve.

Working to meet the health and nutritional needs of women, children and families with information, education, and quality care, MFHS is currently seeking a full time Credentialing and Cash Receipts Specialist to work in our Admin location.

Job Summary:

The Credentialing & Cash Receipts Specialist will be responsible for managing and performing the required credentialing and re-credentialing of contracted and hired medical providers, and MFHS for insurance and Medical Assistance billing. This position will also process and monitor incoming payments and securing revenue by ensuring timely, accurate, complete and compliant billing, follow-up, verification, reimbursement, posting receipts, and reconciliation.

ESSENTIAL DUTIES AND RESPONSIBILITIES, include but not limited to the following:

· Gather, verify, and maintain information needed from contracted and hired medical providers for completion of credentialing process, and ensure the licensing and credentialing process is completed and in accordance with MFHS and federal/state laws.

· Complete provider credentialing applications, monitor status of applications and follow-up as necessary to complete the process timely and accurately.

· Monitor and ensure all provider licenses, certificates, and credentialing remain current; complete re-credentialing for existing providers when required.

· Serves as primary licensing and credentialing contact, and works with new providers upon onboarding, communicating with providers and the Practice Administrator to obtain missing information and provide updates on credentialing and billing statuses.

· Performs daily processing of all cash receipts from check, credit card, automated clearing house (ACH), or wire transfers and prepare the financial records in the accounting software (Financial Edge).

· Perform reconciliations of insurance payments for entry into Financial Edge.

· Assist with managing periodic and external reporting deadlines and audit requests, and in preparing various monthly allocations across funding sources, and in reconciliation of the credit card accounts.

· Serves as back-up for processing payroll.

· Performs data entry, processing mail, general bookkeeping tasks, and basic clerical tasks such as filing and managing data, records, and reports.

· Assist with other duties as directed.

· Promote and contribute to organizational and programmatic goals.

Qualifications/Requirements/Experience:

· Accounting or Business Degree, Associate Degree or Bachelor’s Degree

· 2 years of relevant credentialing or cash receipts experience.

· Non-profit experience preferred.

· Advanced business writing skills for memos, emails, documents, and other materials.

· Excellent verbal communication skills.

· Mathematical reasoning skills – ability to choose the correct mathematical methods or formulas to solve a problem.

· Deductive reasoning – ability to apply general rules to specific problems to produce answers that make sense.

· Inductive reasoning – ability to arrange things or actions in a certain order or pattern according to specific rules or set of rules.

· Ability to function independently and as part of a team.

· Strong planning and organizational skills.

MFHS offers employees:

· Excellent employee and family medical, dental, and vision Insurance

· 11 paid holidays

· Generous paid time off

o Earn 2 weeks to start, 3 weeks after 2 years, and 4 weeks after 4 years!

o 4 personal days

o Earn sick time beginning your first day

· 100% 401k Company Match (up to 6% of compensation)

· FSA/DCFSA

· MFHS Paid Life and Disability Insurance

· Employee Assistance Programs

· Supplemental Benefits

· Family friendly schedules – no holidays, evenings, or weekends

· Paid training & development

· Flexible leave options

· Wonderfully collaborative and supportive culture

Join our compassionate & caring team!

Please visit www.mfhs.org for more information.

MFHS is an ADA and EEO employer. Persons representing all aspects of diversity are encouraged to apply to apply

Job Type: Full-time

Expected hours: 37.5 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: In person