Credential Specialist

POSITION SUMMARY:

The Credentialing Specialist is a critical company role of which is responsible for credentialing and re-credentialing applications and/or enrollments of the agency and its providers with insurance carriers and other third party payers. The primary responsibility of this role is to ensure Directions for Living and it's providers are credentialed in a timely manner with all appropriate funders. Primary duties include attaining and maintaining the organization's "in network" status with various funders, communicating credentialing status with internal and external stakeholders, updating provider credentials within EHR system, keeping up to date on all credentialing requirements, tracking expirations and renewals of all credentialing contracts and communicating when renewals are due, following up on credentialing related approvals and rejections with insurance carriers, and acting as the liaison between the agency and its funders.

Education Requirement:

1. Some college education preferred or minimum of High School Diploma with five years previous experience may substitute for educational requirement.
2. Certification: Credentialing and/or Billing certification strongly desired
3. Minimum of 2-years credentialing experience preferred.
4. Minimum of 4 years of direct experience with Medicare, Medicaid, HMO and Third Party billing and remittance processes, preferably in mental health.
5. Preference given to those with experience working in a community based service setting.
6. Experience with medical or clinical billing software.

Directions for Living is an essential services provider. All Directions for Living employees must be willing and able to provide vital support and essential services to the people that we serve in the event of an emergency, pandemic or other disaster situation. Essential employees may be required to work in the field, be "on call" and/or be available and able to work remotely providing telehealth services depending on the needs of the individual being served.

EOE/DFW/TOBACCO FREE CAMPUS

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Current Openings for Credential Specialist Jobs at Directions for Living

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