Credentialing Specialist

Harbor Behavioral Health; Toledo (OH); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement plan with company match

Generous paid time off

Job summary

Harbor, Inc. is seeking a Credentialing Specialist to join our Toledo team. This full-time role manages daily credentialing operations for health care providers and maintains practice locations with payer sources.

The ideal candidate has strong organizational skills, attention to detail, and excellent communication abilities to ensure timely credentialing completion. Responsibilities include processing credentialing and privileging, assisting with NPI setup, and providing support to Harbor staff

Qualifications

• High School Diploma or GED required.
• Two years of related experience in credentialing or healthcare administration.

Responsibilities

• Assist Credentialing Coordinator in day-to-day operations.
• Process credentialing and privileging for new and established providers.
• Help staff acquire NPI and complete credentialing enrollment steps.
• Provide third-party technical support to Harbor staff and partners.

Skills

Medical terminology

Communication skills

Time management

Confidentiality

Project management

Customer service

Data entry

Education

High School Diploma or GED

Associate degree in administration/health/behavioral science

Tools

Electronic Health Records (EHR)

Practice management systems

Word processing

Spreadsheets

Job description

Harbor is seeking a Credentialing Specialist to join the Toledo team! This position is responsible for the day-to-day operations of credentialing new and established health care providers and maintenance of clinical information and practice locations with payer sources in a timely and complete manner.

Position is full-time, 40 hours per week.

REQUIREMENTS

Education :

• High School Diploma or GEDrequired.

Experience:

• Must have knowledge of medical terminology and at least two years of related experience.
• Must have excellent communication skills, both verbal and written.
• Must demonstrate an ability to meet deadlines in a multi-functional task environment.
• Requires excellent organizational skills, an operational knowledge working with word processing, spreadsheets, data entry, electronic health record and practice management systems, and other computer related skills.
• Must at all times maintain efficiency and timeliness in all daily activities.
• Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process.
• Provides optimal customer service to meet the organization’s expectations.
• Must at all times be able to maintain the confidentiality of privileged information.
• Excellent project management with ability to follow up on projects and meet deadlines.

Preferred Qualifications:

• Associate degree in administration, health or behavioral science field preferred.
• Behavioral Health experience preferred.

EssentialFunctions and PrimaryResponsibilities:

• Assists the Credentialing Coordinator in the day to day operations
• Performs the appropriate credentialing and privileging processes for both new and established health care providers in a timely and complete manner.
• Communicates with new staff in helping them to acquire their NPI, and of the sequential steps needed to begin the credentialing enrollment process, through completion.
• Provides third-party technical support to Harbor staff providing services under contract with managed care/insurance organizations and with other units within Harbor.
• Assists clinical staff in completing needed credentialing information.
• Maintains credentialing information in National Database and SmartCare.
• Works with many individuals to acquire necessary materials and information, including but not limited to: physicians, facility staff, professional staff, physician’s office staff and hospital staff.
• Performs relevant data entry into the database to ensure consistency and integrity of the data.
• Processes appropriate queries and assists providers in renewing expired credentials and licensure, or any appropriate regulatory credentialing requirements and maintains documentation in the database.
• Monitors collection of all information received; follow up on missing items and/or incomplete forms, submit follow up requests for verifications as needed.
• Ensures that all credentials are current at all times.
• Maintains all credential files ensuring that all correspondence in the credentialing process is accurately filed; is knowledgeable and current on the process and legal/regulatory requirements.
• Maintains clinic information and practice locations with payers.
• Provides optimal customer service to meet the organization’s expectations.
• Provides support to executive management in relation to credentialing.
• Assists in maintaining payer portals, information, and billing systems.
• Keeps current with trends and developments related to essential job competencies, and demonstrates continuous growth.
• Performs other duties and works on special projects as requested.

General Competencies/Performance Expectations:

• Utilizes information technology systems and software applications effectively and in accordance with organizational standards and security protocols.
• Demonstrates sound judgment by analyzing information thoroughly, reaching timely conclusions, and taking appropriate, decisive action.
• Plans, prioritizes, and organizes work to ensure maximum efficiency, productivity, and quality outcomes.
• Actively seeks and utilizes supervision and feedback appropriately to support professional growth and effective job performance.
• Manages time and utilizes leave in accordance with organizational policies and procedures.
• Performs additional duties and responsibilities as assigned to support departmental and organizational needs.

Working Conditions :

• Office-based position.
• Travel expectations: driving their own vehicle for work.
• Exposure to confidential information.
• Potential exposure to behavioral, crisis and environmental situations.
• This position is non-union.

About Harbor:

• A leading provider of mental health and substance use treatment forover 100 years.
• 350+ clinical staffserve over24,000 clientsacross multiple locations and in the community each year.
• Services ranging from counseling, pharmacological management, primary care, psychological testing, case management, substance use treatment, residential services, vocational program, andmore!

Why Work for Harbor?

You will have the opportunity to meet other motivated individuals who are also making a positive impact at our company. Harbor is committed to investing our resources in you! Some benefits of working with Harbor include:

• Medical, dental, and vision coverage
• Retirement plan with company match
• Generous paid time off, sick time, and paid holidays
• Tuition and professional license reimbursement programs
• Clinical supervision hours offered
• Ability to make a difference in your community!

Qualifications

Education

Preferred

Associates or better.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.