Accelerated Urgent Care
Contracting & Credentialing Specialist
Accelerated Urgent Care, Bakersfield, California, United States, 93399
About Us:
Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we've built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care's mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County's Top Urgent Care center 6 years in a row! Dedicated to our employees' career growth; 65% of our Administration and Management team members have been internal candidates! 16 clinics strong across 5 regions in California and growing! Our Core Values: Friendliness, Competence, Respect, Teamwork, Compassion, Hard work, Integrity, Humility, Dedication!
Job Overview: The Contracting & Credentialing Specialist, under the direct supervision of the Billing Manager, under the Director of Finance & Billing, is responsible for coordinating provider and facility licensing, credentialing, and contracting across all applicable regions and health plans. The Contracting & Credentialing Coordinator will work cooperatively with many teams including AUC Leadership, HR, Recruiting, Providers, Operations, Billing, and the Owners, to ensure timely and accurate contracting and credentialing to meet staffing and facility needs in a rapidly growing organization.
Essential Responsibilities: Assist with provider and facility licensing, credentialing, and contracting necessary to ensure claims are paid and cash flow is not disrupted Maintain tracking databases of required provider and facility licenses, certifications, contract statuses, and credentials; in addition, review and update this critical data and the associated documents on an ongoing basis to ensure compliance. Maintain AUC's provider roster to meet organizational goals and staffing needs. Proactively monitor provider licensing to ensure compliance with payers, which includes reviewing practitioner licenses, DEA licenses, and ACLS certifications. Monitor and communicate provider and plan statuses to all stakeholders, including AUC Leadership. Provide contracting and credentialing support to various departments, teams, and individuals within the organization as needed to fulfill business needs. Partner with various health plan representatives to promptly follow up and execute provider and plan approval dates. Work with the Billing Manager to track executed health plan agreements, to ensure claims are billed correctly per the executed agreement. Work with the Billing Manager to ensure new health plan contracts and their associated effective dates are communicated to the appropriate Operations Managers for staff notification and education purposes. Communicate the roster of new providers as they are onboarded to the Billing Team, to ensure claim reimbursements are maximized. Coordinate new provider credentialing which includes sending welcome emails to new providers, in addition be of assistance for any questions or concerns they may have. Under guidance of AUC Leadership, trouble shoot barriers quickly to avoid delays in receiving credentialing approvals. Submit professional liability applications to our broker representative and follow up frequently on approval statuses. Under guidance of AUC Leadership, coordinate and maintain the Supervising Physician matrix along with the associated collaborative agreements, to remain in compliance with the Medical Board and health plan requirements. As needed, work with the Billing Manager to submit Letters of Intent to health plans or medical groups that we are not yet contracted with; educate and build relationships with health plan groups to help expedite the contracting process. Minimum Requirements | Qualifications:
2+ years of experience working with various plan types such as Medi-Cal, Medicare, HMO, PPO, etc., preferably in an urgent care setting. High school diploma or equivalent
Position Type:
Full time, Non-Exempt Position Hours:
Monday through Friday, 8am-5pm Job Type:
Full-time Benefits:
Medical, Dental, Vision, Life and PTO + Stocked Coffee Bar COVID-19 considerations: Our team follows and adheres to CDC requirements
Pay Range:
$25.50 - $29.00 per hour
Job Overview: The Contracting & Credentialing Specialist, under the direct supervision of the Billing Manager, under the Director of Finance & Billing, is responsible for coordinating provider and facility licensing, credentialing, and contracting across all applicable regions and health plans. The Contracting & Credentialing Coordinator will work cooperatively with many teams including AUC Leadership, HR, Recruiting, Providers, Operations, Billing, and the Owners, to ensure timely and accurate contracting and credentialing to meet staffing and facility needs in a rapidly growing organization.
Essential Responsibilities: Assist with provider and facility licensing, credentialing, and contracting necessary to ensure claims are paid and cash flow is not disrupted Maintain tracking databases of required provider and facility licenses, certifications, contract statuses, and credentials; in addition, review and update this critical data and the associated documents on an ongoing basis to ensure compliance. Maintain AUC's provider roster to meet organizational goals and staffing needs. Proactively monitor provider licensing to ensure compliance with payers, which includes reviewing practitioner licenses, DEA licenses, and ACLS certifications. Monitor and communicate provider and plan statuses to all stakeholders, including AUC Leadership. Provide contracting and credentialing support to various departments, teams, and individuals within the organization as needed to fulfill business needs. Partner with various health plan representatives to promptly follow up and execute provider and plan approval dates. Work with the Billing Manager to track executed health plan agreements, to ensure claims are billed correctly per the executed agreement. Work with the Billing Manager to ensure new health plan contracts and their associated effective dates are communicated to the appropriate Operations Managers for staff notification and education purposes. Communicate the roster of new providers as they are onboarded to the Billing Team, to ensure claim reimbursements are maximized. Coordinate new provider credentialing which includes sending welcome emails to new providers, in addition be of assistance for any questions or concerns they may have. Under guidance of AUC Leadership, trouble shoot barriers quickly to avoid delays in receiving credentialing approvals. Submit professional liability applications to our broker representative and follow up frequently on approval statuses. Under guidance of AUC Leadership, coordinate and maintain the Supervising Physician matrix along with the associated collaborative agreements, to remain in compliance with the Medical Board and health plan requirements. As needed, work with the Billing Manager to submit Letters of Intent to health plans or medical groups that we are not yet contracted with; educate and build relationships with health plan groups to help expedite the contracting process. Minimum Requirements | Qualifications:
2+ years of experience working with various plan types such as Medi-Cal, Medicare, HMO, PPO, etc., preferably in an urgent care setting. High school diploma or equivalent
Position Type:
Full time, Non-Exempt Position Hours:
Monday through Friday, 8am-5pm Job Type:
Full-time Benefits:
Medical, Dental, Vision, Life and PTO + Stocked Coffee Bar COVID-19 considerations: Our team follows and adheres to CDC requirements
Pay Range:
$25.50 - $29.00 per hour