Credentialing Specialist

Duties and Responsibilities

• Multistate payer enrollment and re-credentialing  

• Maintaining Credentialing software and Payer Portals 

• Demonstrates ability to balance competing deadlines with accuracy and professionalism 

• Ensure that the company complies with federal and state regulations regarding licensure and certification of all professionals 

• Maintain data for all providers and track the expiration of certifications and licenses 

• Ensure that company provider/professionals timely update certification or licensing as required 

• Understand and adhere to HIPAA policies  

• Adhere to Cultivate policies and procedures 

•  Perform other duties as assigned 

Qualifications

• Associate degree or equivalent training  

• Minimum of three (3) years of experience  

• Credentialing certification is preferred 

Knowledge, Skills and Abilities

• Process driven and detail-oriented  

• Excellent organizational and time management skills including the ability to effectively multi-task and prioritize appropriately to deliver timely results 

• Highly motivated and energetic during work hours 

• Communication skills, both oral and written, that are clear, confident, exhibit leadership, professionalism, empathy, and inspire confidence 

• Advanced problem-solving skills and the ability to think ‘big picture’ and execute defined goals and plans 

• Ability to work full-time (40 hours/week), including some flexibility regarding schedule changes required to accommodate patient and staff needs 

• Basic understanding of technology utilized in the field of ABA, including data collection software, to execute high quality services with the ability to learn and oversee practice management tools 

• Experience and competency with Microsoft Office Suite including Word, Excel, PowerPoint, and Outlook email and Calendar 

• Ability to successfully complete and pass a Background and Drug Screen 

Working/Physical Conditions:  

• Ability to bend, kneel, crouch, and stand as well as an ability to lift items up to 25 lbs. 

• Endurance to move rapidly from a seated position to a standing position to perform required tasks 

• Requires eye-hand coordination and manual dexterity enough to operate office equipment, etc. 

• Clerical responsibilities and administrative work require appropriate levels of vision and hearing abilities 

• Ability to communicate effectively using a variety of audio and video meeting platforms and electronic devices