Key Facts

Remote From:

Oregon (USA) , Washington (USA) , Wisconsin (USA)

Full time

English

Hard Skills

Medical Billing ICD 503 CPT Coding Healthcare Industry Knowledge Strategic Positioning Process Improvement

Other Skills

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Communication
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Social Skills
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Teamwork
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Leadership
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Mentorship
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Problem Solving

Roles & Responsibilities

Bachelor’s degree in a healthcare or business-related discipline, or equivalent experience
At least three years of medical insurance, billing or claims experience preferred
Knowledge of medical billing and ICD-10, and CPT coding
Strong knowledge of HIPAA privacy and security rules and regulations

Requirements:

Oversight of all credentialing activities including completion and submission of applications
Work with payors to add new locations to existing contracts
Perform initial review of new payor contracts and suggest changes
Identify and suggest process improvement goals to support operations

Caravel Autism Health

About Caravel Autism Health

Caravel Autism Health delivers top quality in-home intensive, post-intensive, pre-intensive, and diagnostic evaluation services to children with Autism Spectrum Disorder. Caravel Autism Health emphasizes individualized goals based on proven, evidence-based treatment approaches - mainly Applied Behavior Analysis. We specialize in the delivery of Verbal Behavior Therapy, Lovaas, and interactive play approaches, matching the best approach (or combination of approaches) to the individual needs and learning style of the child. Our therapy team is managed by highly skilled, well-trained, and caring senior clinicians. We work one-on-one with children with Autism to first establish a fun, positive, and playful relationship. As children learn to cooperate, imitate, and attend to others, the focus turns to increasing other major skill areas including (but not limited to) language, socialization, play, academic, and self-help skills. Social play with peers and transitions into school environments are introduced and carefully managed as children are ready. Individualized goals are broken down into manageable components based on the child’s learning preference. This way the therapy approach remains positive while children experience success. Therapeutic effectiveness is continually monitored by measuring progress and assessing the amount of fun the child is having during therapy. The goal of our autism therapy is to have every child learn as many new skills as possible in order to maximize his or her potential. The majority of children look forward to therapy because they have fun and are put in a position where they are successful! Other common elements of our Autism Spectrum Disorder program includes: Picture Exchange Communication System, sign language, social stories, video modeling, meaningful generalization of skills to natural environments, parent/caregiver training and involvement in the therapy process, community support, school consultation and support.

Company type: Large

Founded: 2018

Company size: 1001 - 5000

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Job description

The Credentialing Specialist is responsible for all credentialing activities and initial analysis of new contracts.

Essential Functions:

Responsible for the oversight of all credentialing activities. This includes completion and submission of applications and following up with providers and payors on incomplete items.

Works with payors to add new locations to existing contracts.
Maintains good working relationships with payor contacts.
Performs initial review of new payor contracts and suggests changes to discuss with Director.
Acts as a credentialing resource for providers.
Ensures department operations are performed in an accurate and timely manner.
Identifies and suggests process improvement goals to support operations.
Develops and maintains partnerships across all other departments, partners, and vendors to develop and integrate solutions in support of business objectives.
Performs other duties as assigned

Physical Demands:

This is largely a sedentary role, with frequent sitting and computer keyboarding required. Employee will be required to sit, talk, hear, type and write. Occasional bending, squatting, stooping, and lifting (up to 35 pounds) are required.

Qualifications:

Education:

Bachelor’s degree in a healthcare or business-related discipline, or equivalent experience
Certification is a plus

Experience:

At least three years of medical insurance, billing or claims experience preferred

Skills and Competencies:

Knowledge of medical billing and ICD-10, and CPT coding, as well as knowledge of financial concepts
Strategic focus, with the ability to identify and execute on key business strategies that will support attainment of overall organizational business objectives
Ability to effectively lead, coach, manage, mentor and develop others, holding staff accountable as appropriate
Excellent interpersonal skills, with the ability to communicate effectively with others
Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere
Displays professionalism and represents organization in a professional manner
Strong knowledge of HIPPA privacy and security rules and regulations

Caravel Pay Details:

$18.00 to $20.00

Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown. At Caravel we provide competitive wages with excellent benefits, including medical and dental insurance, employer-matched 401(k), paid time-off, paid travel, short-term disability and more.

Important: Credentialing Specialist is a Full Time remote/work from home opportunity, and we are open to candidates in the Spokane, WA OR Green Bay, WI areas