Utilization and Credentialing Manager

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

Work Location Information

This position is hybrid remote, there might be deemed occasions that on on-site visits are needed. This role is specific for our Indiana region of offices.

Summary Of Position

Serves as the leader that manages and develops aspects of the back office operational activities for the Support Services Teams. Works to integrate the operational services with Centerstone’s mission to help improve process and performances for the delivery of high quality services. Oversight of the Manage Care, Credentialing, and Data Integrity teams.

Essential Duties & Responsibilities

• Oversight of the Manage Care Department. Responsible for all related aspect of opening the financial side of the electronic record. This includes obtaining prior authorizations, eligibility inquires and verification of funding sources in order to bill services in an efficient and timely manner.
• Oversight of the Credentialing Department responsibilities. Maintain a working knowledge of payer requirements for credentialing processes and continue to be apprised of changes as it relates to licensure and payer regulations.
• Oversight of Data Integrity Team, responsibility includes processes for resolutions to services errors, communicate notices regarding possible solutions needed. Maintain a working knowledge of all regulatory guidelines and standards to ensure documentation reflects billing activities.
• Responsible for document management processes in the electronic medical record.
• Communicates regularly with support services management team regarding processes and procedural issues.
• Collects, analyzes data integrity related to support services.
• Promote a departmental culture of cooperation and collaboration with other Centerstone departments.
  
  

Knowledge, Skills & Abilities

• Effectively communicate via written, verbal, in person and virtual methods.
• Familiarity with HIPAA related rules and regulations.
• Excellent verbal and written communication skills.
• Active listening skills.
• Experience in health care setting with an electronic medical record
• Limited billing experience is highly preferred
• Experience and knowledge in credentialing preferred
• Proficiency in MS Office (Word, Excel).
  
  

Qualifications

Education Level

High School Diploma Required. Bachelor's Degree Preferred

Years of Experience

Minimum of three (3) years of related experience in health care service.

One To Three Years Supervisory 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

Full time

Entry Pay Range

$40,102.00--$50,024.00

Benefits

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)
• Diversity, Equity, and Inclusion 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 beliefs toward diversity and inclusion.

Our approach to diversity is simple—it’s about embracing everyone. Together, we continue to develop an inclusive culture that encourages, supports and celebrates the diverse voices and experiences of our employees. It powers our innovation and connects us closer to each other, to our clients and the communities we serve. We strive to create a workplace that reflects the growing world around us, and where everyone feels empowered, safe and welcomed.

Salary : $40,102 - $50,024