A New Leaf is seeking a detail-oriented and organized Credentialing Specialist to join our team. This position plays a crucial role in ensuring that all healthcare providers and staff meet the necessary licensing, certification, and accreditation requirements to deliver high-quality services. The Credentialing Specialist will be responsible for managing the credentialing process, including initial credentialing, re-credentialing, and ongoing monitoring of compliance with regulatory standards. The ideal candidate will have a strong understanding of healthcare regulations, excellent communication skills, and the ability to work collaboratively with various departments to maintain the highest standards of care.
Hourly Pay Range: $21 - $25
Schedule: Monday - Friday; 32 - 40 hours a week between 7am - 5pm
Location: Mesa AZ
QUALIFICATIONS Education: High School or GED required. Bachelor's degree, preferred Experience: Credentialing experience must be in the behavioral health field, with a minimum of 2 years experience. Experience required with working with the Arizona Department of Health Services, The Department of Child Safety and accreditation agencies such as Joint Commission/COA/CARF. Ability to work independently. Excellent attention to detail. Proficient in Microsoft Office applications. DUTIES AND RESPONSIBILITIES: Responsibilities will include but are not limited to: Maintain compliance with regulatory and accrediting bodies, participate in the development and implementation of credentialing processes and procedures, governance bylaws, department rules and regulations, organizational policies, and processes. Process provider and agency location credentialing and recredentialing applications Enroll providers with all appropriate client health plans. Review all applications for completion and accuracy and ensure appropriate follow-up; monitor and report on the credentialing progress of each provider and location. Maintain an accurate and up to date provider and location credentialing database to track new application completion; review application progression; ensure timely renewal of credentialing applications; track expiring documentation (certifications, licenses, insurances etc.), and conduct the necessary follow up to obtain up to date documentation. Utilize extensive internet and telephone communication to obtain critical pertinent information. Perform and analyze primary source verifications. Use the CAQH and NPDB systems as required for credentialing purposes. Maintain electronic data files for all providers. In conjunction with the Human Resources Department track departures and new hires to ensure internal provider credentialing is accurate and current. Collaborate with other relevant departments (such as Revenue Cycle Management and Behavioral Health Programs) to ensure credentialing aspects relating to these departments are accurate and current. Coordinate with Foster Care to ensure Foster Care licenses are accurate and current. Collaborate with the Quality Management Department to submit CLIA (Clinical Laboratory Improvement Amendments) Certificate of Waiver applications and track renewals. Collaborate with Quality Management for preparing and submitting facility licenses (new and renewals) Work in collaboration with relevant departments to ensure credentialing compliance with The Joint Commission. Any other duties as directed by the agency. Compliance/Requirements: Class One Fingerprint Clearance Card Valid Driver's License with reliable transportation Current Auto Liability Insurance CLEAN 39 Month Motor Vehicle Record Must Be At Least 21 Years of Age Other details Pay Type Hourly
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