Merakey is seeking a Payer Credentialing Specialist to join our Business Operations team in our Harrisburg, PA location.
The Payer Credentialing Specialist will develop and maintain relationships with practitioners, site and program directors along with the provider support specialists at the various payer sources. Responsibilities include but are not limited to the following.
- Ensure that appropriately completed credentialing and re-credentialing applications are submitted to every contracted payer for each Merakey employed or contracted Physician, Practitioner, other licensed providers (NP, Physician Assistant, Psychologist, LCSW, LPC, etc) in timely fashion
- Ensure and maintain active Medicare and Medicaid enrollments for all qualified Physicians, Practitioners, other licensed providers
- Respond timely to all written, verbal, and electronic payer request regarding missing or additional information necessary to complete the credentialing/re-credentialing process for each Physician, Practitioner, other licensed provider.
- Maintain the accuracy of Physician/Practitioner payer credentialing records in CAQH, PROMISE, PECOS, (credentialing software), and other formats accepted by contracted payers
- Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all
- Provide periodic updates with regard to credentialing status of any new Physician/Practitioner
- Research and respond to all inquiries from Merakey sites and CBO staff related to claims denied for "provider not credentialed" and other related set-up issues
- Assist with special projects as assigned by supervisor
- Participate in Activities Management meetings/calls as requested or assigned
- This position may require minimal travel, 0-10% between Admin Buildings
MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS
- Work/Life Balance
- Competitive Compensation Plans
- Opportunities for professional growth and advancement
- Medical, Dental, and Vision Insurance Plans
- Flexible Spending Accounts
- Short/Long Term Disability Coverage
- Life Insurance
- 403B Retirement Plan (with company matching)
- Marketplace Savings Program
- Employee Assistance Program
- Wellness Programs
- 24-Hour Nurse Hotline
- Tuition Reimbursement
- Generous Paid Time Off (for qualifying positions)
- Stability that coincides with working for a national leader in education and human services
Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country.
We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations.
We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential.
With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, and Tennessee.
For more information on Merakey and our various divisions, please visit: www.merakey.org
Merakey is an Equal Opportunity Employer!
APPLY TODAY www.merakey.org/careers
Requisition # 50086
- Associates Degree, Bachelor's Degree, and/or equivalent work experience
- At least 2 years credentialing experience working with CAQH, Provider Enrollment, etc.
- Proficient in Microsoft Word, Excel, and Outlook
- Experience using time management skills such as prioritizing/organization and tracking details and meeting deadline of multiple projects with varying completion dates
- Ability to work independently and within a group, with minimal daily supervision.
- Strong analytical and problem solving skills,
- Excellent writing and verbal communication skills.
- Local and distant travel required.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled