Credentialing Administrator

Community Medical Services (CMS) is hiring a Credentialing Administrator to maintain credentialing records, files and reports for all staffed physicians, nurses, licensed counselors and all CMS facilities. This role will also prepare and submit required credentialing applications and primary source documents to state, federal and statement Health Maintenance Organizations for initial and reappointment credentialing. This candidate will work collaboratively with several cross functional teams in our fast-paced, deadline driven environment. 

As you join our mission to help those suffering from substance use disorders reclaim their lives, expect to thrive in a comfortable, welcoming, and fun environment where you are valued for the work you do, championed by passionate leaders, and equipped with the tools and ongoing training you need to achieve your goals. 

Along the way, we’ll invest in your well-being through a benefits package that includes:

• Subsidized medical, dental, and vision insurance
• Health savings account
• Short and long-term disability insurance
• Life insurance
• Paid sick, vacation, and holiday time
• 401K retirement plan with match
• Tuition and CME reimbursement up to 100%
• Employee assistance program to support your mental health and wellness
• Ongoing professional development 

Responsibilities:

• Compiles and processes provider credentialing applications in compliance with federal, state, managed care, and regional requirements.
• Maintains provider data to monitor applicant progress in the credentialing process with Federal, State and Managed Care organizations.
• Ensures consistent documentation and complete verification of provider credentials.
• Coordinates data collection from cross functional teams to be included in the credentialing files.Monitors the recruitment status of provider staff candidates to ensure timely credentialing submissions to State Medicaid Agencies, Medicare and HMO’s.
• Assists in the review of provider files.
• Maintains credential and peer review files, e.g. keeps all licensure, certifications, etc. current.
• Loads all applicable rendering providers into CMS Electronic Medical Record System and Electronic Health Record System.

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Education, Certification and Experience Requirements:

• Requires an education level of at least a high school diploma or GED. Associates or Bachelor degree preferred.
• At least 3 years healthcare credentialing experience is required.
• Basic familiarity with healthcare / medical industry is required.
• Computer skills to include PDF, Microsoft Word, Excel and basic data entry, including the ability to learn new and complex
• computer system applications.
• Strong oral and written communication skills; ability to interact with all levels of internal and external contacts.
• Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.

Tools and Equipment Requirements:

• The ability to use a phone, computer, printer, and copier is required.
• Frequent use of Microsoft office products, including but not limited to Outlook, Word, Excel, and PowerPoint.
• The ability to use the internet and various web browser software is required.

Physical Working Conditions and Office Setting Description:

• Requires sitting and standing associated with a normal office environment.
• Manual dexterity using a calculator and computer keyboard.
• Requires prolonged sitting, standing, frequent bending, stooping, or stretching.
• Some lifting may be required.
• Frequent and prolonged typing and frequent and prolonged operation of computer, keyboard, and telephones required.
• Requires occasional use of fax machines, telephones, copiers, and other office equipment.
• Employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift
  and or move up to 50 pounds.

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