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The Credentialing Specialist conducts the initial and renewal credentialing of all the overall Agency as well as all of its eligible providers. Assists the Billing Director in facilitating specialized billing / finance functions to meet department specific and organizational goals. Provides administrative assistance and helps support BCC’s billing and finance departments.
Essential Job Functions
1. Completes provider initial and renewal credentialing applications.
2. Completes agency credentialing and revalidations.
3. Tracks and follows-up with employees and contractors on renewal of insurance credentialing.
4. Researches and resolves all issues related to credentialing in a timely manner.
5. Maintains all credentialing files and reports.
6. Communicates effectively and professionally with internal and external customers.
7. Ensures confidentiality of all records and information whether received orally, as in telephone conferences, as well as by electronic and hard-copy transmission, or by any other method including information generated, information that employees provide, and information that is discussed and disseminated in the Administration area.
8. Performs all other related duties and responsibilities as assigned.
Associate’s Degree in Business or related field with 2-4 years of general credentialing and administrative support experience. Certified Provider Credentialing Specialist (CPCS) certification preferred.
All offers of employment are contingent upon the following: 1) Receipt of results of a satisfactory drug and alcohol screening test. 2) Receipt of the originals of the following background checks: PA State Police Criminal History, PA State Child Abuse, and DPW FBI Criminal History. These clearances must be valid within the 12 months prior to employment. A conviction is not a bar to employment, however a review will be conducted to make a determination of employment should a conviction be present. 3) Receipt of original documentation and verification of relevant degrees, diplomas, certificates, or licensure. 4) Confirmation that you are not on the OIG Federal Healthcare Program Exclusion from Participation list. Should you appear on this list, Berks Counseling Center is prohibited from employing you.