Job Information
BrightSpring Health Services Contracting Credential Specialist in LOUISVILLE, Kentucky
Our Company
BrightSpring Health Services
Overview
Do you have a passion for establishing partnerships and strategies in achieving organizational excellence? Our Business Development & Sales teams focus on developing strategic solutions to align and grow the business. Continue reading for information regarding this position and apply today!
Responsibilities
The Credentialing Assistant is responsible for the processing of initial credentialing, privileging, re-credentialing and re-privileging applications of health care providers, as well as processing provider enrollment applications and supporting documentation for payer enrollment and re-enrollment. The position maintains the provider files and reports, status of applications and pertinent licenses and certifications. He/she has knowledge of commonly used credentialing concepts, practices and procedures to perform the functions of the job and must be detail oriented and thorough in order to ensure the complex enrollment packages are complete and correct. Communication with providers and others within the organization is essential.
Work with providers in person, by phone, fax, mail or email to obtain provider credentialing and insurance enrollment forms and all supporting documentation
Maintain current and accurate data needed for the credentialing and re-credentialing process for all providers
Conduct thorough background investigation, research and primary and secondary source verification of all components of the application file per regulatory requirements
Identify issues requiring additional investigation and evaluation; validate discrepancies and ensure appropriate follow up
Maintain copies of current state licenses and any other required credentialing documents for all providers
Respond to inquiries from other healthcare organizations regarding credentialing and privileging issues as they arise
Follow up with providers to ensure that all necessary information is received and that the enrollment process is completed timely
Maintain up-to-date documentation and insurance files with applications, acceptance letters, provider numbers and completed provider enrollments
Retain detailed and accurate lists of insurance plans in which providers participate and their effective dates with each plan
Re-credential providers as required by individual insurance plans
Perform other duties as assigned
Qualifications
Associates Degree in business or health related field preferred
Three years Credentialing and Provider Enrollment experience preferred
Must be an organized “self-starter” requiring little supervision in order to focus on and accomplish tasks
Professional written and verbal communication and interpersonal skills required
Ability to maintain complete confidentiality in handling sensitive enrollment issues
Ability to prioritize and multitask in a fast-paced environment
Strong attention to detail required
Proficiency in Microsoft Office, particularly Excel, Word, and Outlook
Database management skills including querying reporting and documentation generation
Knowledge of Medicaid and Commercial Payer Provider Enrollment preferred
About our Line of Business
BrightSpring Health Services provides complementary and integrated home- and community-based pharmacy and health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive care and clinical solutions in all 50 states to over 400,000 customers, clients and patients daily. For more information, visitwww.brightspringhealth.com. Follow us on Facebook (https://www.facebook.com/brightspringHS/) , Twitter (https://www.twitter.com/BrightSpringHS/) and LinkedIn (https://www.linkedin.com/company/brightspringhealth/) .
Salary Range
USD $48,000.00 - $55,000.00 / Year
ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at TalentAcquisition@brightspringhealth.com .
Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information.
Job LocationsUS-KY-LOUISVILLE
ID 2024-157145
Line of Business BrightSpring Health Services
Position Type Full-Time
Pay Min USD $48,000.00/Yr.
Pay Max USD $55,000.00/Yr.