Job Description
Job DescriptionDescription:
Who We Are
Pawnee Mental Health is a non-profit Certified Community Behavioral Health Center (CCBHC) helping underserved populations in 10 counties here in North-Central Kansas.
We are a vibrant community of passionate people looking for our next teammate – you!
What We Offer
At Pawnee Mental Health, we believe in supporting our employees’ well-being with a comprehensive benefits package. This includes top tier benefits like:
Medical & Vision Insurance: Accessible plans to support your health needs offered through BCBS or Aetna – prices for single coverage between $50-100/month.
Dental Insurance: 100% FREE for employees.
Kansas Public Employee Retirement System (KPERS): Secure your future with KPERS retirement benefits - a lifetime pension program.
Other insurances: Life insurance coverage up to 150% of your annual income and long-term disability insurance at NO COST.
Paid Holidays: Enjoy 8 paid holidays throughout the year.
Generous PTO: Start earning 10 hours of PTO per month (15 days/year), jumps to 24 days/year on your first anniversary.
Paid Medical Leave: Receive a 40-hour bank of paid medical leave IMMEDIATELY upon hire.
Employee Assistance Program (EAP): Access support resources for your personal and professional life.
Supplemental benefits: Additional life insurance coverage, ambulance transportation, short term disability, critical illness, hospital indemnity, and more!
The Role You Play
As the Credentialing Coordinator, you'll support our finance and billing departments by managing insurance credentialing, state client data submissions, and compliance. You'll maintain accurate records, ensure reporting requirements are met, and collaborate with staff and external entities to uphold quality care and regulatory standards. The main duties include:
Insurance Credentialing:
- Prepare, submit, and track provider and facility applications for credentialing and re-credentialing, ensuring records of certifications, licenses, and insurance enrollments are accurate and up-to-date.
- Communicate with insurance payers to resolve issues, monitor credentialing timelines, and prevent lapses in coverage or participation.
State Client Data Submission:
- Collect, verify, and submit client data in compliance with state reporting requirements using the AIMS system.
- Monitor regulatory changes and adjust submission processes as needed, ensuring timely and accurate reporting with thorough documentation for audits.
Compliance and Documentation:
- Maintain adherence to federal, state, and local regulations for credentialing submissions.
- Create and organize detailed documentation of all processes, reports, and communications, supporting audits and reviews when required.
Collaboration and Communication:
- Work closely with providers, staff, and external entities to gather necessary information and address credentialing inquiries.
- Provide updates to management on credentialing and reporting status.
At Pawnee Mental Health, we take a great deal of pride in the services we offer, and the progress made by those we serve. All employees, regardless of their role, are an important part of our success! To help us achieve our mission, we’re looking for bright and talented people with great ideas. We believe individuals and families with mental health and/or substance use challenges should have the opportunity to lead normal, productive lives at home and in their communities. If you feel the same, we invite you to explore the opportunity below to see how you can make a difference!
We look forward to reviewing your application!
Requirements:
Required
- Bachelor’s degree in healthcare administration, business, or a related field or equivalent experience, with 1 year of experience substituting for 1 year of education.
- Minimum of 2 years of experience in insurance credentialing and/or state data submission.
- Familiarity with healthcare regulations, payer requirements, and data reporting standards.
- Strong organizational and time management skills.
- Excellent attention to detail and problem-solving abilities.
- Proficiency in relevant software applications (e.g., Microsoft Office Suite, credentialing systems, and data submission platforms).
- Effective communication and interpersonal skills.
Preferred
- Experience in credentialing providers in a behavioral/mental health setting.
- Experience credentialing providers for a large organization (50+ providers).
- Knowledge of SQL or other programming language.