Remote Audit Jobs in Boca Raton, FL (NOW HIRING)

(Remote) Provider Contracting and Credentialing Coordinator

Mental Health & Addiction Field

*Must live in the US in EST and reside in the Eastern (ET)or Central Time (CT) Zone

Hours: 8:00am to 5:00pm ET

Pay Starts: $21+/hr

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues. We put behavioral health front and center, providing assistance to people with substance abuse issues, addictions and mental health concerns.

With facilities in various regions of the U.S., we have been furthering this mission since our inception, applying our advanced approach to patient care.

Every facility in the Advanced Recovery Systems network strives to provide the highest quality of care, using evidence-based therapeutic models that really work. Our goal is to help men, women and adolescents live healthy, happy lives without the burden of substance abuse or mental illness.

Benefits include:

• Health, Vision, Dental, Employer Matched 401(k)
• STD, LTD, and Employer Paid Term Life Policy - up to $50k
• Employer Matched HSA – up to $1500 a year company contribution
• Employee Wellness Program – reduce employee premiums $40/mo
• Free MDLive telehealth benefit
• Paid Time Off - Vacation/Personal/Holiday/Sick
• Employee Referral Bonus

The Provider Contracting and Credentialing Subject Matter Expert (SME) is responsible for assisting the organization with payer contracting efforts, including but not limited to; provider applications, contract analysis, negotiations, credentialing of facilities and medical/clinical providers. This position ensures the contracting and credentialing department works successfully with multiple departments including Sales/Marketing, Finance, Legal, Compliance, Medical and Operations.

CORE JOB DUTIES:

1. Ensures that all medical and clinical staff are appropriately credentialed with all payers, and payer requirements.
2. Assists the credential manager in identifying new hire needs to ensure appropriate credentials are inline with payer needs.
3. Reviews and prepares payer credentialing applications and recredential application for completeness and accuracy.
4. Works with providers and credentialing department to ensure required information is available to complete processes.
5. Works in tandem with ARS Teams (Business Development, Marketing and Finance) to identify opportunities for company growth in terms of managed care contracts.
6. Evaluates and analyzes contract proposals and works with SVP to negotiate best possible contract rates for ARS.
7. Direct contact and liaison between payers and ARS facilities as it relates to contracts, addendums, and credentialing needs.
8. Conduct quality control audits of files and take necessary actions to remediate and prevent future errors.
9. Prepare reports for internal and external use.
10. Works with billing department to address non-participation or dis-enrolled providers.

Requirements

QUALIFICATIONS:

• Minimum of High School Diploma or Equivalent; Bachelor’s Degree Preferred.
• Minimum three (3) years’ experience in provider or payer contracting and credentialing.
• Knowledge of Hospital and/or Behavioral Contracting and Reimbursement.
• CAQH requirements and profiles, credentialing and re-credentialing applications for facilities and payer contracting.
• Strong Computer Knowledge.
• This role requires the employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards.
• Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.)
• an “up to date” antivirus software.
• Workining camera and microphone
• ARS does offer some reimbursement for remote office equipment.

Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues.

We invite you to learn more about us at our website!

The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO.

We are proud to be a drug-free workplace.

Benefits

We offer great benefits including 401(k), paid time off plan, medical, dental, vision, and much more.