Job Description
Job Description
Job Description
Harbor is seeking a Credentialing Specialist to join our 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.
Education/Experience/Other Requirements:
- Associate degree in administration, health or behavioral science field preferred.
- Behavioral Health experience preferred.
- 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.
Essential Job Competencies/Primary Duties:
- 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.
About Harbor:
- A leading provider of mental health and substance use treatment for over 100 years
- 350+ clinical staff serve over 24,000 clients across 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, and more!
Why Work for Harbor?
It is fast-paced and challenging, but you will have a lot of fun in the process. 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
- Employee referral bonuses
- Ability to make a difference in your community!
Job Tags
Full time, Contract work, Work at office,