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Education:

A high school diploma or GED is typically required; an associate's degree is a plus.

Experience:

Some experience in medical billing, insurance authorization, or a related field is strongly preferred.

Skills:

Credentialing, Provider Enrollment, CAQH, Medicaid, Medicare, Prior Authorizations, Utilization Review, Insurance Verification, Behavioral Health Healthcare, Compliance, HIPAA, CARF, Joint Commission, Revenue Cycle Management Responsibilities Include:

Coordinate provider credentialing, recredentialing, and payer enrollment for behavioral health providers. Submit and track enrollment applications with Medicaid, Medicare, and commercial insurance carriers. Maintain provider records, licenses, certifications, liability insurance, and compliance documentation. Perform primary source verification and monitor credential expirations to ensure ongoing compliance. Verify insurance eligibility, benefits, and authorization requirements for behavioral health services. Initiate, submit, track, and follow up on prior authorization requests, denials, and appeals. Collect and maintain patient demographic, insurance, and clinical information to support medical necessity reviews and authorization requests. Serve as a liaison between providers, patients, and insurance companies to facilitate credentialing, authorizations, and reimbursement processes. Collaborate with internal teams and payer representatives to resolve credentialing and authorization issues. Maintain accurate data entry, reporting, and audit-ready records in compliance with HIPAA, CARF, Joint Commission, payer, and regulatory requirements.

Job Type:

Full-time Pay:

From $11.00 per hour

Benefits:

Dental insurance Flexible schedule Health insurance Vision insurance

Work Location:

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Find & Apply For Enrollment / Eligibility Specialist Jobs in Van Buren, Arkansas

Credentialing/Authorizations Specialist