Provider Enrollment/Credentialing Specialist (ZR_20724_JOB)

This is a remote position.

• Contract type: Independent Contractor
  
• Night Shift Schedule: Monday to Thursday - 8:45am to 5pm New York Time (8:45pm - 5am Manila Time)
  
• Friday - 8:45am to 3:45pm New York Time (8:45pm - 3:45am Manila Time)
  

• Maintain individual providers with up-to-date information needed to complete credentialing by the state and govt rules.
  
• Maintain the provider information in various systems utilized by different practice groups.
  
• Ensure appropriate log-ins are available.
  
• Update each provider's database in a timely fashion and according to the carrier’s schedule.
  
• Complete revalidation requests by payers and carriers.
  
• Stay on top of near expiring licensing certificates and/or liability insurance information.
  
• Complete credentialing applications for providers with commercial payers and Medicaid.
  
• Complete re-credentialing for commercial payers and Medicaid.
  
• Work closely with the other teams in MBH to identify and resolve denials and authorizations in claims related to credentialing.
  
• Follow up on status and open escalation tickets for submitted or denied credentialing applications.
  
• Prepare email communication with relevant information to be sent to practice groups by the provider enrollment rep.
  
• Attend daily meetings with provider enrollment member.
  
• Attend weekly team meetings, completing the to-do’s assigned to provider enrollment member. 
  
• Other duties as assigned 
  

Requirements

Knowledge/skills/abilities:

• Detail orientated with above-average organizational skills
  
• Able to plan and prioritize to meet deadlines
  
• Excellent verbal and written communication
  
• Communicates clearly and effectively
  
• Excellent reading comprehension
  
• Excellent computer skills, including Microsoft programs such as Excel, Word
  
• Thorough understanding of navigating the internet
  

Education/experience required:

• 4-year college degree
  
• Two years experience in US-based medical billing practice or 
  
• Two years experience in a medical practice dealing with billing including but not limited to, provider credentialing, authorizations, reimbursement, etc. preferably in Behavioral Health to some degree
  

MBH Core Values: We hire/fire/promote based on these core values + job-specific performance:

1. Respectful of our unique cultural environment 
   
2. Absolute Confidentiality 
   
3. Embracing Teamwork
   
4. Loyal Behavior & Positive Attitude
   
5. Accountability 
   
6. Proactiveness 
   
7. Thoroughness 
   
8. Focused on results
   
9. Inspired to learn & grow constantly 
   
10. Devoted to providing top-tier services to our clients through the "MBH Unique Service Oriented Philosophies"
    

Benefits

• Permanent work from home
  
• Immediate hiring
  
• Steady freelance job
  
• Profit sharing incentive
  
• Paid time off
  
• Holiday pay
  
• Annual Performance and Raise Evaluation
  
• Quarterly Perfect Attendance Incentive
  
• HMO
  
• BruntWork Loan Assistance