The Credentialing Specialist conducts the initial and renewal credentialing of all the overall Agency as well as all of its eligible providers. Assists the Billing Director in facilitating specialized billing / finance functions to meet department specific and organizational goals. Provides administrative assistance and helps support BCC’s billing and finance departments.
Knowledge, Skills, and Abilities
• Knowledge of credentialing and insurance functions and federal, state and local related laws.
• Knowledge of BCC services, policies, and procedures.
• Knowledge and understanding of trauma and how it impacts others.
• Skill in active listening and collaborative communication.
• Skill in Microsoft Office and Microsoft Outlook.
• Skill in managing competing priorities.
• Skill in problem solving and conflict resolution including identification of the problem or conflict.
• Ability to communicate professionally with coworkers, clients and vendors.
• Ability to take initiative on tasks as needed.
• Ability to work independently and meet established goals.
• Ability to follow written and oral instructions.
• Ability to organize daily activities of self and others and to work as a team player.
• Ability to maintain strict confidentiality and abide by HIPAA regulations.
• Ability to engage in honest, transparent and respectful interactions with others.
• Ability to act with integrity and work from a place of empathy and compassion.
Essential Job Functions
1. Completes provider initial and renewal credentialing applications.
2. Completes agency credentialing and revalidations.
3. Tracks and follows-up with employees and contractors on renewal of insurance credentialing.
4. Researches and resolves all issues related to credentialing in a timely manner.
5. Maintains all credentialing files and reports.
6. Communicates effectively and professionally with internal and external customers.
7. Ensures confidentiality of all records and information whether received orally, as in telephone conferences, as well as by electronic and hard-copy transmission, or by any other method including information generated, information that employees provide, and information that is discussed and disseminated in the Administration area.
8. Develop an understanding of trauma and how it impacts others.
9. Incorporate trauma informed practices into job duties and responsibilities, including interactions and communications with others.
10. Be an active member of BCC’s culture of caring through positive and engaging social interactions.
11. Performs all other related duties and responsibilities as assigned.
SEEING: Must be able to see well enough to read reports and use computer.
HEARING: Must be able to hear well enough to communicate to clients, vendors and coworkers.
MOBILITY: Must have mobility to move about the agency. Must have mobility to move about the community.
LIFTING/PUSHING/PULLING: Must be able to lift up to 10 pounds.
OTHER: Must be able to write, type and use technology.
Note: The statements herein are intended to describe the general nature and level of work being performed, but are not to be seen as a complete list of responsibilities, duties, and skills required of personnel so classified. Also, they do not establish a contract for employment and are subject to change at the discretion of Berks Counseling Center. Berks Counseling Center is an equal opportunity employer.