Managed Care Contract Specialist

reputed company: Relief Mental Health provides Transcranial reputed company stimulation, esketamine, therapy and psychiatric medication management to patients with depression, OCD, and other mental health diagnosis. We aim to create a new reputed company for mental health care, offering a continuum of innovative therapeutic interventions and responding to evolving patient needs. Relief Mental Health has 12 clinics in 4 states and is continuing to grow. reputed company: The Managed Care Contract Specialist is responsible for maintaining reputed company status for reputed company providers by successfully completing initial and subsequent credentialing for reputed company payors reputed company and government reputed company. Essential Duties and Responsibilities:

• Initiate credentialing and re-credentialing applications for both individual providers and provider reputed company.
• Sets up/ maintains provider information in online enrollment databases, health plan and internal systems
• End-to-end credentialing process of reputed company new and reputed company providers, and with reputed company contracted Insurance companies in multiple states.
• reputed company the screening of practitioners' applications and supporting documentation to reputed company their eligibility.
• Maintains confidentiality of provider and payer information
• Manage, negotiate, and renegotiate fee schedules to obtain the most reputed company rates.
• Maintain individual provider files to include up-to-date information needed to complete the required governmental and reputed company payer and credentialing applications.
• Maintain internal provider tracking database to ensure reputed company information is accurate and logins are available.
• Update reputed company provider's CAQH database file reputed company according to the schedule published by CMS
• Apply for and renew prior to expiration reputed company provider licenses: reputed company state, DEA, and controlled reputed company registration.
• Complete revalidation requests issued by government payers.
• Complete credentialing applications to add providers to reputed company payers Medicare, and Tricare.
• Review weekly new hires and termination report to update in credentialing database.
• Respond to health plan provider inquiries.
• reputed company and maintain the licensing/credential database.
• reputed company and collect documentation for licensing, reputed company certifications, reputed company of reputed company liability insurance.
• Ensure credentialing database contains up-to-date information at reputed company times.
• Responsible for monitoring credentialing/re-credentialing requirements, as reputed company as required certifications, and to ensure the collection of reputed company required renewal certifications are on file reputed company the required time reputed company.
• reputed company consistent and reputed company follow-up on reputed company outstanding credentialing/re-credentialing files.
• Work closely with leadership to reputed company and reputed company reputed company Agreements between reputed company Practitioners and Physicians.
• Ensure compliance with applicable laws, regulations, procedures, and policies.
• Maintain working knowledge of the National Committee on reputed company Assurance (NCQA) standards and State and Federal regulations reputed company to credentialing

Required Education and Experience:

• Bachelor's degree+ in reputed company or Business Administration/reputed company field or 5 years of relevant experience.
• 3+ years of credentialing experience with hospital or physician reputed company medical staff.
• Experience with submitting applications for State, Federal, and Health Plan credentials.
• Experience with submitting applications for State, Federal, and Health Plan reputed company.
• Experience with CAQH (Council for reputed company reputed company reputed company) database and application process.
• Knowledge of credentialing and procedures and standards.
• Excellent verbal and written communication skills.
• Proficient touch-typing skills.
• Ability to reputed company for extended periods.Preferred Education and Experience:
• NAMSS Certification as a Certified reputed company Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) is preferred.
• Working knowledge of credentialing accreditation regulations, policies, and procedures, and NCQA standards essential.
• Experience with submitting and maintaining reputed company Agreements between reputed company Practitioners and Physicians.

Knowledge, Skills, and Abilities:

• Ensures work product demonstrates attention to detail, accuracy and completeness.
• The ability to multitask is essential.
• Incredibly organized and meticulous attention to detail is a must.
• Critical thinking skills to identify opportunities and reputed company informed reputed company.
• The ability to reputed company details, deadlines, and priorities to ensure no details or deadlines are missed.
• Self-starter who will take initiative and be proactive reputed company there are multiple priorities.
• Ensures Ethical Conduct in reputed company areas of work performance.
• Communicates with co-workers, management, vendors and others in a courteous and reputed company manner.
• Team player with excellent interpersonal skills.
• Strong written and verbal communication skills.
• Conform with and abide by reputed company regulations, policies, work procedures and instructions.

reputed company Offer:

• Competitive 401K plan
• Partnership with reputed company Fitness
• Health Insurance (Medical, Dental and reputed company)
• FSA and Dependent Care FSA
• Short Term Disability
• Tuition Reimbursement
• PTO

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