Credentialing Specialist

Job Summary
We are seeking a detail-oriented and organized Credentialing Specialist to join our team at our Southfield, Michigan location. In this role, you will be responsible for managing the credentialing process for mental health providers, ensuring compliance with industry standards and regulations. The ideal candidate will possess a strong understanding of insurance carrier operations, mental health office operations, and medical terminology, allowing them to effectively navigate the credentialing landscape. This is a hybrid position and candidates must live in the Detroit, Michigan area as familiarity with the local insurance carriers is essential.

Responsibilities

• Conduct thorough verification of credentials for mental health providers.


• Maintain accurate and up-to-date records of provider credentials and documentation.


• Collaborate with various departments to ensure compliance with insurance carrier requirements.


• Review applications for completeness and accuracy, following established standards.


• Communicate with providers regarding the status of their credentialing applications.


• Stay informed about changes in regulations and standards related to credentialing processes.


• Assist in the development and implementation of policies and procedures related to credentialing.


• Regularly review insurance carrier member portals to ensure accurate company information is displayed for optimum referral generation.

Requirements

• Certified Provider Credentialing Specialist (CPCS)


• Certified Billing and Coding Specialist (CBCS)


• Proven experience in a mental health office or healthcare setting is preferred.


• Strong knowledge of insurance carrier processes and medical terminology.


• Excellent attention to detail and organizational skills.


• Ability to work independently as well as part of a team.


• Proficient in using computer systems and software relevant to credentialing tasks.


• Strong communication skills, both written and verbal, to effectively interact with mental health providers and staff.

Join our dedicated team as a Credentialing Specialist and contribute to ensuring high-quality care through effective provider credentialing practices.

Job Types: Full-time, Contract

Pay: $22.00 - $23.00 per hour

Benefits:

• 401(k)


• Dental insurance


• Flexible schedule


• Health insurance


• Paid time off


• Vision insurance

Schedule:

• 10-hour shift


• 8-hour shift


• Day shift


• Evening shift


• Monday to Friday


• Weekends as needed

Work Location: Hybrid but must reside in the Detroit, Michigan area.