Credentialing Specialist

• Works collaboratively with ABA leadership and staff to facilitate a positive credentialing experience
•  Collects and maintains required information and documents necessary for credentialing
• Tracks documentation, submission and approval dates by payer
• Submits required documentation to insurance companies, government payers, and other third-party payers
• Maintains database of all credentialed staff regarding status in credentialing process as well as timelines for any
• re-credentialing
• Collaborates with the Accounting team, providing information as needed to ensure denials are addressed quickly
• Notifies appropriate internal parties when staff are credentialed by insurance companies, government payers, and other third-party payers
• Seeks the best use of materials, equipment and staff to maximize efficiency and effectiveness
• Acts as a good steward of Damar and/or client finances
• Shows initiative by identifying solutions to work towards improving stakeholder satisfaction
• Prioritizes duties in a manner consistent with organizational objectives and growth
• Maintains documentation that is accurate and legible
• Adheres to all policies and procedures as defined in the Employee Handbook, ABA Operational Policies and
• Procedures, and Damar Operational Policies and Procedures Manual
• Takes pride and ownership in Damar’s facilities and assigned work areas.
• Respects the culture, diversity and rights of all clients, their families and the community
• Performs other duties as assigned

• High School Diploma or GED required; Associate or Bachelor's degree in healthcare administration or related

  field preferred

• Minimum of 1 year of relevant experience in a healthcare setting required; credentialing experience

  preferred

• 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 18 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.

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