Find & Apply For Clinical Auditor / Utilization Reviewer Jobs in Jonesboro, Arkansas

Job Title:

Credentialing Specialist Location:

NextStep Counseling Services, LLC Reports To:

Director of Accounts Job Summary:

The Credentialing Specialist plays a key role in ensuring the smooth operation of both billing and credentialing processes within a mental health clinic. This position is responsible for managing the hiring, onboarding, and credentialing processes for clinical staff, ensuring compliance with applicable regulations, and supporting clinic operations by maintaining accurate records and documentation.

Credentialing Responsibilities:

1.

Provider Credentialing:

○ Manage the credentialing process for all mental health providers (therapists, counselors, psychiatrists, etc.) ensuring compliance with insurance payers, regulatory agencies, and accreditation bodies. ○ Verify qualifications, licenses, and certifications of clinical staff and submit applications to insurance companies, government agencies, and other entities as required. ○ Track the status of applications, renewals, and expirations of professional licenses and certifications. 2.

Compliance and Documentation:

○ Ensure all necessary documentation is accurately completed and maintained for each provider, including malpractice insurance, background checks, and required training. ○ Maintain compliance with industry standards and state and federal regulations regarding credentialing and licensing. ○ Liaise with insurance carriers and government entities regarding credentialing status and updates. 3.

Provider Enrollment:

○ Facilitate provider enrollment with insurance panels, ensuring the clinic remains an active provider with insurance networks. ○ Assist in ensuring that providers meet the necessary requirements for reimbursement from insurance companies. 4.

Audits and Reporting:

○ Assist in the preparation for audits and inspections from regulatory agencies or accrediting bodies. ○ Generate and maintain reports on credentialing and HR activities for management review. 5. Perform other duties as assigned.

Qualifications:

• Bachelor's degree in Human Resources, Healthcare Administration, or a related field (preferred).
• 2+ years of experience in HR, credentialing, or healthcare administration (mental health or medical field experience preferred).
• Strong understanding of healthcare regulations, compliance requirements, and credentialing processes.
• Experience with HR software, credentialing management tools, and Microsoft Office Suite.
• Excellent attention to detail and organizational skills.
• Strong communication and interpersonal skills.
• Ability to handle sensitive and confidential information with discretion.

Job Type:

Full-time Benefits:

401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s): Do you have experience with Arkansas Medicaid, Passe and Private Insurance credentialing?

Work Location:

Hybrid remote in Jonesboro, AR 72401