October 28, 2024

Left Hand Management

Englewood

FULL TIME

Enrollment/Credentialing Specialist-Behavioral Health

Enrollment/Credentialing Specialist-Behavioral Health
Starting Pay Range $24-$26 per hour
Englewood, Colorado
We are growing again and looking for the right Enrollments teammate!
The Enrollment Specialist will facilitate the enrollment application process through all stages to enroll behavioral health agencies or individual providers with commercial and/or government payors.
This position is responsible for entering or updating practitioner information in both internal software and with external payors. In addition to data entry, the Specialist maintains copies of licensure, works with providers to collect certificates, and other supporting documents necessary for the credentialing process. The Enrollment Specialist maintains provider CAQH profiles, and conducts verification of all data, ensuring accuracy and compliance before completing enrollment applications in timely manner.
Job Duties

Gather and review supporting documentation from providers including licensure certificates, CAQH information, liability insurance information and more.
Assist clients with CAQH Profiles or NPI attainment as needed.
Complete the application for enrollment process for new and existing agencies or individual behavioral health providers, ensuring applications are completed timely and precisely.
Follow up on the status of applications, including tracking in our project management system and reporting progress to internal teams and our providers.
Maintain timelines on enrollment/credentialing schedules, communicate with providers and other departments to update regularly, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
Maintain provider information in multiple payor platforms in a timely and accurate manner.
Maintain responsibility for your own provider accounts and all enrollment files, advocating for your providers through the process.
Occasionally research changes in enrollment processes, requirements or Provider Types.
Foster and maintain professional relationships with portfolio of client agencies.

Preferred Qualifications

High school diploma or equivalent.
Two years’ previous experience in a related job in a health care setting with a working knowledge of behavioral healthcare terminology, insurance carrier policies and procedures, State and Federal rules and regulations.
Ability to analyze problems and strategize solutions.
Knowledge of medical credentialing procedures and standards.
Familiarity with HIPAA privacy requirements for patient information.
Proficient in Microsoft Office Suite; working knowledge of insurance payor portals a strong plus.
Database management skills including querying, reporting and document generation.
Strong customer service skills
Communicate effectively both verbally and in writing.
Work independently and as part of a team
Ability to multitask, detail oriented and able to prioritize work with minimal direction and oversight.