Job Description
Job DescriptionIT’S MORE THAN A JOB. IT’S A CALLING. At Family Care Center, we are on a mission to transform lives by elevating behavioral health care. Our journey began in 2016 when two U.S. Army Veterans founded Family Care Center to help service members, Veterans and their families. We continue that tradition today, caring for people of all ages across a broad range of conditions with nearly 30 outpatient clinics in communities across Arizona, Colorado, Florida, Tennessee and Texas. If you'd like to work for one of the nation's fastest-growing behavioral health providers, collaborating with other committed team members and making a positive impact on your community, we look forward to hearing from you.Transforming lives is our life’s work.
- CARING & SUPPORTIVE CULTURE: We support you so you can support our patients. Our positive environment is complemented by an engaging wellness program, volunteer events, team activities and more.
- UNPARALLELED GROWTH OPPORTUNITIES: We offer clear paths for career advancement at every level, fostering your professional development and personal growth.
- BALANCED LIFESTYLE: Achieve professional fulfillment while nurturing a healthy work-life balance, free from weekend or evening hours. We understand the importance of both professional fulfillment and personal well-being.
- COLLABORATIVE TEAM: Join forces with a diverse team of top-notch behavioral health professionals, support staff and empowering leadership. Together, we work towards transforming the lives of our patients.
- IMPRESSIVE RETENTION RATES: Our compassionate, welcoming approach has helped us earn a higher-than-average provider retention rate of 88%.
- COMPREHENSIVE BENEFITS: We prioritize your overall well-being and financial security. Enjoy a full suite of competitive benefits, including medical, dental, fertility, retirement, wellness, profit sharing and more.
Position Summary: The Credentialing Specialist works closely with each provider and coordinates all functions related to the credentialing and recredentialing of health care providers and maintains provider credentialing files. The Credentialing Specialist ensures that the organization is operating within state and federal regulations and provides integral support to healthcare operations by enabling timely onboarding of providers.
Essential Responsibilities:
- First point of contact for providers in the credentialing process. Communicates clearly with providers and receives and processes all initial credentialing and recredentialing applications.
- Provides elite customer service to providers and ensures that credentialing and recredentialing of providers occurs on a timely basis in accordance with industry and company standards and criteria.
- Collects all pertinent information from the provider, provider’s malpractice insurer, National Practitioner Data Bank (NPDB) and other sources as deemed appropriate.
- Enters, updates, and maintains data from provider applications into credentialing database, focusing on accuracy, and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.
- Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.
- Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines. Prepares all documents to be reviewed by the Credentialing Committee and attends Credentialing Committee meetings and takes minutes.
- Maintains well-organized provider files that are easily reviewed by credentialing committee, outside review bodies, and others. Processes timely approval, denial, or termination letters.
- Ensures providers medical staff files are complete and contain all necessary applications and licenses relative to the credentialing and privileging process and meets all timelines and schedules.
- Maintains provider CAQH profile to ensure accuracy of information and necessary documentation upload, in addition to completing requisite and timely updates, CAQH re-attestation, and other special project assignments as necessary.
- Perform quarterly provider audit for OIG and SAM status and any other regulatory audit requirements.
- Maintains strict level of confidentiality on all matters pertaining to provider.
Other Duties:
- Performs other related duties as assigned by management.
Supervisory or Managerial Responsibility:
- None
Minimum Qualifications:
- High school diploma or general education degree (GED) required, Bachelor’s Degree Preferred.
- Two years’ experience in a health care setting required, prior experience in delegated credentialing preferred.
- Experience using credentialing software (i.e., credential my doc) preferred. Advanced knowledge of Microsoft Office and advanced knowledge of Excel. Possesses the ability to use spreadsheets, graphing, and tables.
Work Environment and Conditions:
- Continually required to sit, utilize hand, and finger dexterity, talk, and hear.
- Work environment is usually quiet to moderate.
- Frequently working at a desk in front of a computer.
- Occasionally required to lift and/or move up to 15 pounds.
Annual Salary Range: $55,000 - $68,000
Family Care Center offers competitive compensation and benefits packages with the ability to also maintain work-life balance. Full time employees are eligible for 401k, vision, dental, medical, life, and employee wellness and discount plans.
Family Care Center is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.