Credentialing Coordinator - Melville, NY

Click Below To Apply

Application

Refer a Friend!

Refer

Wage: TBD
Department: Administrative
Position Type: Full Time
Location: Melville, New York


Achieve Beyond is a national Pediatric Therapy and Autism Services agency. With offices in New York (Metro area/Long Island, Hudson Valley & Albany), New Jersey, Virginia/DC area, Connecticut, Maryland, Delaware, and California (greater Los Angeles & Orange County, San Francisco and San Diego). Achieve Beyond provides quality evaluation and therapy services such as special education, autism services, speech, physical, and occupational therapies to children birth through twenty-one years of age via telehealth, in clinic and in homes and the community.

We are looking for a dynamic, professional, and hardworking Credentialing Coordinator to join our team. The Credentialing Coordinator processes new hires as well as following up on provider documentation to ensure current providers remain compliant.

We believe that all children have potential. We are guided by the mission to support children with special needs to Achieve Beyond their current abilities. We are always striving for continuous improvement by setting goals and measuring performance.

It is the reason we will succeed together

Responsibilities:

  • New Hire Process
    • For ALL providers assist with the following tasks:
      • Create CAQH and add to Admin Account
      • Update Claims with Compliance Types and Attributes
      • Keep NHSS up-to-date
      • Send complaint email when credentialing process is complete
      • Follow up on missing documents
      • Follow up with Insurance Companies on Credentialing documents
      • Update Central Reach
    • Keep New Hire Spread Sheets up-to-date
    • Send complaint email when credentialing process is complete
    • Create CAQH (for Salaried Insurance providers only)
  • Follow up on in-process insurance clearances for providers
  • Follow up on expiring or expired documents
  • Assist Salaried providers with applying for licenses/certifications
  • Assist with applying for new insurance contracts
  • Follow up on insurance contracts that have been applied for
  • Re-Attest CAQH (for Salaried Insurance providers)
    • Complete Initial applications
  • Complete Re-Attestation requests
  • Process provider rate increases
  • Assist Contracting
  • Research requirements & request information
  • Complete forms/submit request letters
  • Complete & submit Group Rosters
  • Complete & submit provider applications
  • Other duties as assigned by manager

Requirements:

  • Knowledge of Microsoft Office programs such as Word, Excel, PowerPoint, and Outlook. Must be able to create spreadsheets
  • Able to take initiative & work independently when necessary
  • Solution focused and willing to drive issues to resolution with appropriate persistence and persuasiveness
  • Have a friendly disposition with the ability to establish and maintain effective working relationships with fellow co-workers, as well as providers and insurance representatives


Benefits Include:

  • Personal and Sick Time
  • Medical/dental/vision coverage
  • Paid Holidays
  • 401k with matching
  • Short-term, long-term disability, life insurance
  • Employee Recognition Events-and so much more!

*Please note that this role's location is a full-time in office position.

Click Below To Apply

Application

This job description is subject to change at any time.
Achieve Beyond provides equal employment opportunities to all employees and applicants and prohibits discrimination and harassment of any type regarding race, color, religion, age, sex, national origin, disability status, genetics, caregiver status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. If you are an individual with a disability requesting an accommodation for the application process, please contact us for assistance.

Return to the careers page