Credentialing Coordinator

• Establishes and maintains positive and efficient relationships with Medicaid, Managed Care Organizations, and Third-Party Payers• Collects and maintains required information and documents necessary for credentialing• Submits required documentation to insurance companies, government payers, and other third-party payers• Tracks documentation, submission, and approval dates by payer• Maintains database of all credentialed staff regarding status in credentialing process as well as timelines for any re-credentialing • Monitors and tracks the status of healthcare and behavioral healthcare providers through the credentialing process• Maintains and tracks contracts with insurance companies, government payers, and other third-party payers ensuring contracts are current and reflect all services provided through the contract• Communicates with insurance companies, government payers, and other third-party payers, as needed, through the credentialing process of staff• Maintains notifications of staff as they are credentialed by insurance companies, government payers, and other third-party payers• Notifies appropriate internal parties when staff are credentialed by insurance companies, government payers, and other third-party payers• Collaborates with other departments, such as Accounting, ABA, and Health Services, to ensure all necessary credentialing documents are current  • Regularly reviews denials with the revenue cycle team, ensuring any credentialing issues are resolved in a timely manner for resubmission and collection• Prioritizes duties in a manner consistent with organizational objectives and growth• Shows initiative by identifying solutions to resolve credentialing issues• Acts as a good steward of Damar and/or client finances• Seeks the best use of materials, equipment, and staff to maximize efficiency and effectiveness• Takes pride and ownership in Damar’s facilities and assigned work areas• Will adhere to all policies and procedures as defined in the Employee Handbook and Damar Operational Policies and Procedures Manual• Completes and updates mandatory training and other licensure related items in a timely manner• Maintains documentation that is accurate and legible• Performs other duties as assigned

• Associate’s or Bachelor’s degree required
• Minimum of 3 years of credentialing experience in a healthcare setting
• Strong knowledge of the credentialing process and payer requirements
• Knowledge of HIPAA regulations and patient privacy laws

• Proficiency in using electronic health record systems

• Proficiency with MS Office applications including: Word, Excel, Outlook and PowerPoint

• Certification as a Credentialing Specialist (CPCS) is a plus

• Ability to pass and maintain CPR certification

• Minimum age of 21 per licensure requirements
• Valid Indiana driver’s license and driving record that meets eligibility requirements of Damar’s insurance carrier (for all positions requiring driving)
• Be clear of any felony convictions, substantiated charges of neglect or other disqualifying criminal convictions
• Successfully complete a pre-employment physical
• Favorably meet and maintain Damar’s background screening

Essential Job Functions:

Physical: Primary functions require sufficient physical ability and mobility to work in an office setting; to stand or sit for prolonged periods of time; to occasionally stoop, bend, kneel, crouch, reach, and twist; to lift, carry, push, and/or pull light to moderate amounts of weight (up to 35lbs); to operate office equipment requiring repetitive hand movement and fine coordination including use of a computer keyboard; to travel to other locations using various modes of private and commercial transportation; and to verbally communicate to exchange information.

Vision: See in the normal visual range with or without correction.

Hearing: Hear in the normal audio range with or without correction.

#DSCorporate