Crossroads Health provides a continuum of quality life-changing behavioral health and specialized chemical dependency treatment services to children, adolescents, young adults, adults and families. As a leader in the behavioral health field, we offer a vast array of programs and services that evaluate, educate, strengthen and support thousands of children, adults and their families each year.
Our finance department is currently looking for a Credentialing and Contract Administrator to become a part of our team. The Credentialing and Contract Administrator will provide support for Billing, Human Resources and Clinical Staff in the contracting and credentialing functions for the organization. This role performs duties needed to get all levels of care provided by the organization contracted, clinicians enrolled, credentialed and rostered in all participating payers, in order to obtain the highest reimbursement for all clinical services offered at Crossroads Health and New Directions.
Primary Responsibilities:
- Responsible for all aspects of contracting with new and existing payers on new business or existing contracts to increase reimbursement rates and make sure all new clinicians are contracted under Crossroads and/or New Directions.
- Responsible for credentialing both new and existing clinicians for all contracted payers, Medicare and Medicaid payers.
- Responsible for following up with payers for any contracting and credentialing issues resulting in denials from the payers.
- Primary contact for maintaining spreadsheet and/or software programs implemented for tracking status of credentialing process for all clinicians.
- Responsible to keep track of revalidation needs for all plans. This included the CAQH process for all independently licensed providers.
Requirements:
- High School diploma required/Bachelor's preferred
- One (1) year experience with credentialing role
- Two (2) years of experience in a Billing Specialist (preferred)
- Experience in the healthcare, nonprofit sector (preferred)
- Certified Professional Credentialing Specialist (preferred)
Our organization is committed to equal employment opportunity. We do not discriminate against employees or applicants on the basis of race, color, religion, gender/sex (including pregnancy, childbirth, and pregnancy-related conditions), sexual orientation, gender identity, national origin, age, physical or mental disability, veteran status, uniform service member status, genetic information, or any other status protected by law.
Visit our website: www.crossroadshealth.org
