Work. With Purpose

ChanceLight autism services, a growing, dynamic organization with a social mission to offer hope, is seeking an individual to join our team.

The primary duties for a Credentialing Specialist will include but not limited to the following:

• Ensure all applicable providers are credentialed for all new and ongoing payor agreements by accurately completing and submitting credentialing applications.
• Effectively track the ongoing progress of applicable credentialing for assigned providers/regions and communicate those results in a timely fashion.
• Track and maintain all credentials to ensure network status is maintained and payor/state requirements are met.
• Understanding of necessary ongoing requirements to maintain Provider credentials with regards to payor compliance:
  • Ongoing training and operational requirements
  • Ensure all necessary providers are credentialed and added to all applicable contracts in a timely and efficient manner
  • Staff and Credentialing needs
  • Collection of necessary documents and maintenance of NPI/CAQH
• Develop and utilize tools and resources for credentialing data and demographic information for best practice.
• Maintain payor relationships and identify all payor updates and
• Complete daily, weekly, and monthly assignments as assigned by Supervisor; special projects may be assigned upon need.

Qualifications

The minimum qualifications for the position include a two-year degree from an accredited college or university OR a minimum of two years of experience in healthcare credentialing or a related field OR an equivalent combination of education and experience.

Employees must have the ability to:

• Exhibit sound and accurate judgement and include appropriate people in decision-making process.
• Adapt to changing situations and have the ability to restructure tasks and priorities as changes occur within the organization a daily, monthly and yearly
• Effectively organize and plan work according to organizational needs by defining objectives and anticipating needs and
• Effectively deal with work related problems, pressure, and stress in a professional and positive
• Effectively work and collaborate with others toward a common
• Communicate clearly and effectively with people inside and outside of the
• Must have the skills, knowledge, and abilities necessary to be effective in the specific functional content of a
• Must develop and maintain positive relationships with individuals within and outside of their work
• Must demonstrate accuracy and thoroughness and look for ways to improve and promote quality.
• Must be consistently at work, on time and take responsibility for completion of assigned job duties.

Physical requirements/ Work Conditions

The physical demands and work environment described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work is normally performed in a typical interior work environment. Work involves minimal exposure to physical risks weight lifting requirements.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)