ABA Payer Credentialing Specialist- Belmont, NC Onsite

Onsite Location(s)

Compleat Kidz - Belmont Clinic
54 Myrtle St , Belmont, NC 28012

Onsite Options

• Domestic

Description
ABOUT US:
Compleat KiDZ is the largest and fastest growing multi-disciplinary rehabilitation treatment organization in North Carolina. What sets us apart is our ability to provide all pediatric services under one roof and our team approach to patient care. We provide Occupational, Physical, Speech Therapy services to children birth to 18 years of age in our 11 clinics.
We are seeking an experience ABA Payer Credentialing Specialist to join our team. This will be a 100% onsite role at our Belmont, NC office.
Duties and Responsibilities:
Compiles and maintains current and accurate data for all providers.
Maintains confidentiality of provider information.
Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
Maintains corporate provider contract files.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Sets up and maintains provider information in online credentialing databases and system.
Tracks license and certification expirations for all providers to ensure timely renewals.
Maintains and updates all providers’ CAQH and re-attest when necessary.
Ensures that NPI enrollment/applications are completed correctly.
Ensures practice addresses are current with health plans, agencies and other entities.
Processes applications for appointment and reappointment of privileges to Kare Partners and all subsidiaries.
Tracks license, DEA and professional liability expirations for appointed providers.
Maintains Provider appointment files, and information in credentialing database.
Ensures proper coordination with providers, payers, and office personnel.
Audits health plan directories for current and accurate provider information.
Performs other duties as assigned.
Education and Experience

• Associate degree or above is preferred.
• Minimum 2 years of payer enrollment processing required.
• Ability to utilize multiple spreadsheets.
• CredentialStream software experience (preferred).
• Knowledge of MCO payer credentialing processes.
• Ability to monitor the onboarding and terminations of all providers in group and update accordingly.
• Experience processing NC Medicaid (NC Tracks) enrollment and revalidation applications.
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KarePartners/Compleat Kidz offers a competitive compensation and benefits package to full-time employees, including medical/dental, vision coverage, FSA, STD, LTD, life insurance, EAP, and company-matched 401(k)._

KarePartners is an Equal Employment Opportunity that values and encourages diversity.
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