CODAC Health
Contracts and Credentialing Specialist
CODAC Health, Tucson, Arizona, United States, 85718
Job Details
Job LocationSpeedway Bldg 2 - Tucson, AZ
Position TypeFull Time
Education Level4 Year Degree
Travel PercentageNegligible
Job ShiftDay
Job CategoryNonprofit - Social Services
Job Posting Date(s)
Start Date10/07/2024
Description
Summary
Responsible for managing all aspects of behavioral health treatment service contract administration including specific technical knowledge regarding provider types and treatment service billing rules. Also responsible for managing all aspects of provider billing credentialing with AHCCCS, Medicare and other commercial insurance plans.
Essential Duties and ResponsibilitiesDevelops and manages payer specific contractsOversees acquisition of provider contracts and agreementsManages provider AHCCCS, Medicare and Commercial Insurance credentialingNegotiates rates with all payersEvaluates ACA/ACO rules and regulations to make recommendations and assist in implementing changesEnsures Billing department and Enrollment department is informed regarding provider contract and credentialing updates to ensure accurate billingCoordinates directly with AHCCCS payers regarding contract matters and provider credentialingEvaluates and reports contract specific trends, CPT and ICD10 changes and its impact on organizationAttends the monthly AHCCCS payer data compliance meetingsPlans and organizes quarterly subcontractor meetingsDevelops and oversees maintenance of a computerized tracking system to ensure completeness of contract files to ensure agency compliance with deliverables.Maintains current process documentation of job dutiesWorks directly with other departments to improve processes and resolve issuesPerforms other related activities in accordance with agency growth and changeQualifications
Education:
Bachelor's degree in Business Administration, Management, Organizational Management or related fieldMaster's degree in Business Administration, Management, Organizational Management or related fieldExperience:
Three years' experience in contract and billing systems related work.Additional Requirements:
Valid Arizona Driver's license, proof of current insurance and willingness to use personal vehicle.Motor Vehicle Record: no more than 2 moving violations or a license suspension in past 3 years.Familiarity with various ethnic and cultural groups.Skills:
Ability to interact effectively with others.Intermediate to advanced computer skills using MS Office products; Project, Word, Excel, Access, etc., importing/exporting data to/from applications.
Job LocationSpeedway Bldg 2 - Tucson, AZ
Position TypeFull Time
Education Level4 Year Degree
Travel PercentageNegligible
Job ShiftDay
Job CategoryNonprofit - Social Services
Job Posting Date(s)
Start Date10/07/2024
Description
Summary
Responsible for managing all aspects of behavioral health treatment service contract administration including specific technical knowledge regarding provider types and treatment service billing rules. Also responsible for managing all aspects of provider billing credentialing with AHCCCS, Medicare and other commercial insurance plans.
Essential Duties and ResponsibilitiesDevelops and manages payer specific contractsOversees acquisition of provider contracts and agreementsManages provider AHCCCS, Medicare and Commercial Insurance credentialingNegotiates rates with all payersEvaluates ACA/ACO rules and regulations to make recommendations and assist in implementing changesEnsures Billing department and Enrollment department is informed regarding provider contract and credentialing updates to ensure accurate billingCoordinates directly with AHCCCS payers regarding contract matters and provider credentialingEvaluates and reports contract specific trends, CPT and ICD10 changes and its impact on organizationAttends the monthly AHCCCS payer data compliance meetingsPlans and organizes quarterly subcontractor meetingsDevelops and oversees maintenance of a computerized tracking system to ensure completeness of contract files to ensure agency compliance with deliverables.Maintains current process documentation of job dutiesWorks directly with other departments to improve processes and resolve issuesPerforms other related activities in accordance with agency growth and changeQualifications
Education:
Bachelor's degree in Business Administration, Management, Organizational Management or related fieldMaster's degree in Business Administration, Management, Organizational Management or related fieldExperience:
Three years' experience in contract and billing systems related work.Additional Requirements:
Valid Arizona Driver's license, proof of current insurance and willingness to use personal vehicle.Motor Vehicle Record: no more than 2 moving violations or a license suspension in past 3 years.Familiarity with various ethnic and cultural groups.Skills:
Ability to interact effectively with others.Intermediate to advanced computer skills using MS Office products; Project, Word, Excel, Access, etc., importing/exporting data to/from applications.