COMCARE Billing Specialist - COMCARE

Sedgwick County; Wichita (KS); On-site; USD 32,000 - 45,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement plans

Professional development

Job summary

Sedgwick County seeks a Credentialing Specialist to manage provider credentialing and related customer service duties in a health services setting. The role involves preparing and submitting credentialing documents to several managed care organizations and maintaining accurate provider records.

Requires prior office experience, strong data entry, and familiarity with credentialing processes. The position offers a comprehensive benefits package and opportunities for professional development

Qualifications

• High School Diploma or equivalent; post-interview tests include MS Excel 70% and MS Word 80%.
• Familiarity with credentialing processes and CMHC/CCBHC licensing standards.
• One year of office or administrative support experience preferred.

Responsibilities

• Submit credentialing and re-credentialing applications to various payors.
• Prepare credentialing documents for licensed providers.
• Maintain provider rosters and update credentialing databases.
• Data entry of provider information into multiple websites.
• Communicate missing credentialing documentation to providers.
• Notify providers about expiring licenses and certifications.

Skills

MS Excel

MS Word

Office administration

Credentialing knowledge

Education

High School Diploma or equivalent

Some college

Tools

OnBase

Avatar

Job description

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Work Schedule: Monday-Friday, 8:00am-5:00pm

Sedgwick County offers a comprehensive benefits package for full-time employees that includes health coverages, paid leave, regular compensation reviews, retirement plans, and professional development opportunities. For more detailed information, please visit our benefits page at SCBenefits .

Submits new and renewal credentialing applications for Health and Human Services’ licensed provider staff to all applicable Managed Care Companies. Monitors the licensing renewal dates of all licensed provider staff.

Provider Credentialing

• Prepare credentialing documents for licensed providers
• Submit both credentialing and re-credentialing applications to various companies
• Compile provider information on roster spreadsheets for the KanCare Managed Care Organizations
• Data entry of provider information into various websites
• Communicate with providers regarding any missing credentialing documentation
• Follow up with payors to obtain credentialing effective dates
• Notify providers when certifications/licenses are within one month of expiration
• Obtain documents and scan into On base
• Submit address/license updates to applicable Managed Care Companies
• Maintain online credentialing database which is accessible by various payers
• Update and maintain staff record within Avatar
• Update and maintain Managed Care panel listings
• Review weekly claim error reports to determine if additional information is needed on the provider record

Customer Service

• Answer phone calls and take necessary action to resolve issue
• Work with provider relations representatives to obtain necessary credentialing information related to submitting credentialing data correctly
• Resource for assisting providers with all Credentialing questions
• Provide notification to COMCARE/Health providers when credentialing status has changed

Minimum Qualifications: High School Diploma or equivalent. One year office or administrative support. Must meet minimum scores on identified skills testing. Post-Interview tests required are MS Excel 70%; MS Word 80%. Meet the specifications as outlined in the CMHC/CCBHC licensing standards and pass KBI, DCF child abuse check, adult abuse registry, and motor vehicle screens. Must complete orientations provided by Sedgwick County and COMCARE.

Preferred Qualifications: Some College. One year credentialing experience.