Credentialing Specialist

Centerstone is among the nation's leading nonprofit behavioral health systems with thousands of employees dedicated to delivering care that changes people's lives. A dynamic, well-established organization, we offer rewarding opportunities to serve all ages in a variety of settings. Come talk to us about joining the Centerstone team!

JOB DESCRIPTION:

SUMMARY OF POSITION

Prepares and submits accurate credentialing/re-credentialing applications for appropriate licensed providers. Responsible for updating and maintaining providers on roster listing as it relates to payers or membership organizations. Responsible for maintaining CAQH and NPI certifications for staff and tracking ANSA/CANS certifications and sending notification alerts to staff.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Prepares and submits accurate credentialing/re-credentialing applications for appropriate licensed providers. This includes maintaining and updating the credentialing database, and submitting the credentialing/re-credentialing information in a timely manner.
• Maintain a working knowledge of payer requirements for credentialing and continue to be apprised of changes as it relates to licensure.
• Responsible for preparing verification communication to appropriate staff when approval for a paneled provider is obtained. Must maintain an accurate listing of facility providers as new licensed providers are employed. Is responsible for updating and maintaining providers on roster listing as it relates to payers or membership organizations.
• Responsible for maintaining CAQH and NPI certifications for staff which included updating via websites and submitting appropriate documents in a timely manner and not to exceed expiration dates. Malpractice and other required organizational information as needed is also maintained within CAQH.
• Reviews licensure information and updates on the Indiana Professional's Bureau for licensed providers.
• Responsible for tracking ANSA/CANS certifications and sends notification alerts to staff.
• Works closely with authorization staff and other organization staff, as it relates to credentialing functions.

KNOWLEDGE, SKILLS & ABILITIES

• Effectively communicate via written, verbal, in person and virtual methods.
• Detailed oriented
• Knowledge of behavioral health terminology
• Proficient in Office for Windows.

QUALIFICATIONS

Education Level

High School Diploma or GED required.

Years of Experience

Two to five years of office experience preferred.

Certification/Licensure

N/A

PHYSICAL REQUIREMENTS

Standing - 20%

Sitting - 80%

Squatting - Occasional

Kneeling - Occasional

Bending - Occasional

Driving - Occasional

Lifting - Occasional

DISCLAIMER

The duties and responsibilities described in this document are not a comprehensive list and additional tasks may be assigned to the employee from time to time, or the scope of the job may change as necessitated by business demands.

Time Type:

Pay Range:

Delivering care that changes people's lives starts with our employees. Below are just some of the great benefits Centerstone employees enjoy:

• Medical, dental, and vision health coverage
• Flexible Spending and Health Savings Accounts
• 403b retirement plan with company match
• Paid time off and ten paid holidays
• AD&D Insurance, Life Insurance, and Long Term Disability (company paid)
• Employee Resource Groups
• Continuing education opportunities
• Employee Assistance Program

Centerstone is an equal opportunity employer. Employment at Centerstone is based solely on a person's merit and qualifications directly related to professional competence. Centerstone does not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), or any other basis protected by law.

At Centerstone, we use our values as a guide for what we do. Respect, Expertise, Integrity and Empowerment are at the heart of every interaction at Centerstone, and particularly rooted in our Culture.

Our approach to culture is to create an environment that encourages, supports and celebrates the voices and experiences of our employees. We are committed to a culture of empowerment, respect, integrity and expertise that powers our innovation and connects us to each other, our clients and the communities we serve.

Centerstone is also committed to a strong culture of quality and safety, celebrating role-models who champion best practices for quality, clinical risk, and patient safety.