Credentialing / Reimbursement Specialist

Aliviane; El Paso (TX); Hybrid; USD 23,000 - 25,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k)

Paid time off

Extended illness leave

Paid holidays

Mental health hours

Career growth

Flexible schedule

Half day Friday

Life insurance

Short-term disability

Job summary

Aliviane Inc. is seeking a Credentialing / Reimbursement Specialist to manage credentialing and contracting requests from a remote/office-based setting in El Paso, TX.

The role collaborates with billing to ensure timely processing and accurate reporting of credentials for providers and facilities. Ideal candidates will have a CPCS or similar credentialing certification, plus 5 years of relevant experience, and a strong understanding of payer requirements and systems like PEMS/CAQH/CMS.

Qualifications

• Associate degree or technical school completion.
• At least 5 years of similar work experience.
• CPCS or similar certification preferred.
• Experience in Behavioral Health preferred.
• Excellent verbal and communication skills.
• Attention to detail in documentation and deadlines.
• Knowledge of payer requirements for provider types.
• Familiarity with PEMS, CAQH and CMS.

Responsibilities

• Submit, track, and respond to credentialing and contracting requests.
• Assist billing department with assigned tasks.
• Monitor licensure and credentialing for facilities and providers.
• Follow up on all applications and provide up-to-date reports.
• Work independently, set priorities, and meet deadlines.
• Support with billing projects.
• Collaborate with management on licensure planning.
• Gather information from new providers to complete credentialing.

Skills

Verbal communication

Attention to detail

Payer requirements knowledge

PEMS/CAQH/CMS knowledge

Education

Associate degree or technical school

CPCS certification preferred

Behavioral Health experience preferred

Tools

PEMS

CAQH

CMS

Job description

Company name: Aliviane Inc.

Title of position: Credentialing / Reimbursement Specialist

Position type: Full Time

Pay: $17.00 - $18.00

Location: Remote / Office

1626 Medical Center St. El Paso, Texas 79902

Benefits:

We offer our team –

• Medical, dental, and vision insurance and 401(k)

• Generous paid time off, extended illness leave, and paid holidays

• Mental Health Hours

• Excellent growth and development opportunities

• Satisfying and rewarding work helping clients overcome substance abuse

• Flexible Schedule

• Half day Friday

As well as company-paid benefits such as life insurance and short-term disability!

About Us

Aliviane Inc. is committed to providing treatment to members of our community who struggle with substance abuse. Through substance use and mental health services, education, and awareness we help people recover from addiction as they embrace their voice, discover their journey, and engage their community. The success of our mission is made possible by the skills and contributions of our diverse team. Become a part of a unique organization that is spearheading substance use treatment in Texas. Become a part of Aliviane!

Job Summary

This position's main responsibility will be submitting, tracking, and responding to credentialing and Contracting requests. Will also assist billing department with specific assignments

Essential Duties and Responsibilities

• Collaborate with management to plan and track facility/group and individual provider licensure and credentialing.
• Connect with new providers to gather needed information and facilitate the completion of credentialing.
• Monitor and track staff credentials and licensure.
• Consistently follow up and track the status of all applications and provide up to date reports.
• Ability to work independently, set priorities and meet deadlines with a strong sense of urgency.
• Performs other duties as assigned.
• Assist with billing projects.

Additional Eligibility Qualifications

• Excellent verbal and communication skills.
• Attention to detail in composing, typing, and proofing materials, establishing priorities, and meeting deadlines.
• Excellent knowledge of applicable payer requirements for the different provider types.
• Excellent knowledge of PEMS, CAQH and CMS.

Required/Preferred Education and Experience

• Associate degree or completion of technical school program
• 5 years similar work experience
• Certified Provider Credentialing Specialist (CPCS) or similar certification preferred.
• Experience in Behavioral Health (Preferred)