Mental Health Credentialing Coordinator - Remote

Job Description

Job Description

Who We Are

Rivia Mind is a tele-behavioral Mental Health and Well-being Practice based in NYC, with services across New York, New Jersey, Connecticut and Florida.

We are an interdisciplinary group of psychiatry and psychology providers, supportive operational staff and contributors who focus on delivering accessible, reliable, and quality evidence-based holistic treatment.

We primarily see adult patients and deliver diverse services, including psychopharmacology, psychotherapy, and specialty offerings.

We have a dynamic team to address people's needs beyond just medication management. Our employees operate in a collegial atmosphere with collaborative team dynamics and mutual self-improvement opportunities.

Here, we foster a culture of respect, diversity, and inclusion for all. Our employees are actively engaged by a culture that reinforces our beliefs and is guided by our mission, vision and values.

To l earn more about our Practice, please check our website at www.riviamind.com.

What makes Rivia Mind unique :

• We foster continuous learning, engaging collaboration, and excellence in all that we accomplish together
• We support a comprehensive approach in our philosophy of care that considers various factors and perspectives through the delivery of evidence-based treatments
• We are setting the new standard for accessible, reliable, and quality Mental Health services with positive patient experiences
• We are inspired by our Rivia Community of patients, providers, colleagues, and partners who are driven by the commitment to make a positive impact

Job Summary

The Credentialing Coordinator supports company goals by ensuring that every clinician is appropriately credentialed with each insurance carrier.

The ideal candidate has passion and drive, integrity, high attention to detail, and professionalism to accomplish department goals.

At Rivia Mind, we embrace smooth processes, collaboration, and excellence in what we do. We're looking for a Credentialing Coordinator with excellent organizational skills and follow-through, robust communication skills, and a personable disposition to ensure timely and accurate enrollment of providers in insurance panels.

Job Posted : September 11, 2024.

Application Window : Closes September 16, 2024.

Job Responsibilities & Qualifications

Responsibility Composition

50% - New Provider Applications and Ongoing Renewals- ensure complete information is collected and submitted for each provider in compliance with payer requirements and internal service level agreements (SLAs)

25% - Follow up, Issue Resolution and Confirmation of execution for submissions

15% - Proactive review of payer set up / accuracy for current providers

10% - Special Initiatives / Ad Hoc projects including Process Documentation and Improvements

• Commits to providing excellent customer service internally & externally, including but not limited to follow-up on credentialing applications, provider correspondence to update documents, etc.
• Actively participates in companywide and departmental meetings.
• Promote a friendly work culture that encourages a fun, collaborative, and co-learning environment that benefits individuals well-being, self improvement and potential
• Perform other related role and team function duties as assigned by department supervisor and group leaders

Compliance : Adheres to all policies and procedures as outlined in the employee handbook. Understands and complies with all HIPAA rules, regulations and company policies.

Keep up to date with department policies and procedures and adjust as needed according to current laws and compliance mandates.

• Understand facility licensing for all required states within Rivia Medical, PLLC Offices - Completes in-network requests and applications for assigned facilities
• Adhere to all internal standards of operation (SOPs), timelines, and SLAs for submissions and follow-ups

Accurate Data : Ensure completeness and accuracy of all information entered into applications and databases. Update the database with any applicable changes.

Upload all documentation to Symplr and ensure timely upkeep of expiring documents. Monitor and correspond with providers regarding applicable expiration and renewals of licensures and certifications.

• Proactively set and monitor daily, weekly, monthly tasks in Symplr database to keep providers current in all aspects of credentialing.
• Identify trends and 'Red Flags' of any negative information found with immediate notification to the Credentialing Supervisor.

Requests follow-up documentation as necessary.

Credentials Files : Contribute to maintaining credentialing files for all clinical roles. Information is placed in the files correctly and timely, as per policy.

Adhere to & maintain documentation protocol, notates accounts and reports appropriately (i.e. within Symplr, Credentialing & Licenses Spreadsheet, etc.)

Practitioner Profiles : Assist in maintaining practitioner profiles, obtain data from other departments as required. Compiles data and organizes for the department Supervisor to review.

• Assist in any initial research for facility credentialing as requested and support the credentialing process for all accounts to ensure every account is appropriately credentialed with each insurance carrier.
• Acquire all necessary documentation to submit applications for onboarding clinicians and onto new payers as needed.
• Conduct as-needed audits when requested by the Credentialing Supervisor.

Qualifications

Required Education Level : High School Diploma or Equivalent

Additional Qualifications, Skills & Attributes

• 2-4 years of Credentialing experience in Mental / Behavioral Health or / and Medical Healthcare
• Preferred 1+ years of experience credentialing in Mental / Behavioral Health for the following credentials : LCSW, LMSW, MD, DO, NP / PMHNP, etc.
• Proficiency with using Symplr Credentialing Database preferred
• Medicare & Surrogacy Experience Required
• Experience working with online payers - delegated & non-delegated accounts
• Familiar with credentialing for large national, regional and government payers such as : *Aetna, *Cigna / Evernorth, ComPsych, *Horizon / Empire BCBS, *UHC / Optum, Humana, Carelon, Tricare East, First Health, Harvard Pilgrim
• Must have proven experience with CAQH and NPPES enrollment
• Attentive to details and goal-oriented
• Ability to work efficiently with minimal oversight and within deadlines
• Strong interpersonal skills and proven ability to work in a team environment
• Ability to set, prioritize, manage and complete multiple tasks within deadlines
• Proficient with utilizing a diverse range of technology platforms and systems (Google Suite required, company wide platforms / software like Monday.

com and EHR / EMR platforms when applicable)

• Intermediate computer skills and technical aptitude required
• Job Description Responsibilities and Qualifications are subject to change based on the needs of the Business

Benefits

We offer a comprehensive benefits package that includes :

Medical & Financial

• Medical, Dental, and Vision Insurance benefits are eligible on the 1st of the following month from your start date
• Optional enrollment in a HSA, FSA, or / and DCA per applicable plan
• Employer-paid Life and Accidental Death and Dismemberment (AD&D) Insurance, Short Term and Long Term Disability Insurance
• Competitive Pay
• 401(k) plan with immediate employer match and vesting
• Employee Referral Bonus Program

Paid Time Off & Leave

• Annual paid week off between Christmas and New Year's Day while the practice is closed
• Company Observed Holidays
• Generous Annual Paid Time Off (PTO) that is pro-rated for the remainder of the year based on start date (Tenure schedule for PTO increase too!)
• Family Medical Leave (FLMA), Parental Leave, and Military Leave
• Paid Bereavement Leave (up to 5 days) and Paid Pet Bereavement / Medical Care Leave (up to 2 days)

Development & Engagement

• Annually allotted Paid Professional Development Days after one year of employment
• Professional Development Allowance after one year of employment
• Free Development Courses through our Learning Management System (Relias)
• Virtual and In-Person Social Events, Activities, and Community Support

Compensation & Employment Details

Pay Range : $50,000 - $60,000

Please note : Location and experience are heavily weighted compensable factors with salary.

We do not extend offers at the top of the range due to ability to account for merit increases within the role at performance review time.

Pay Type : Salary

Department : Credentialing

Supervisor : Credentialing Supervisor

Supervisees : None

Employment Status : Full Time (40 hours a week)

Minimum Hours : 40

Exemption Status : Non-Exempt W-2

Work Environment : Remote

Work Schedule : Monday - Friday

Eastern Time Zone

Interview Process : 3 Interviews - Recruiter, Supervisor, COO

Compensation Determination :

Rivia Mind is committed to equal and transparent pay. Please note that the salary range information is a general guideline and combines various labor markets within the US.

The range displayed on each job posting reflects the minimum and maximum range of potential pay for this role. It is uncommon for an individual to be hired at or near the top of the range for their role.

Our compensation salary ranges or pay rates are determined by various factors.

• Job Qualifications, Job Responsibilities, Job Employment Level, Skills
• When applicable, Location, Work Environment, Licensure & Certifications, Specialty Experience, Education & Training, etc.

Your recruiter can share more about the specific salary range for this role during the hiring process.

Please note that the compensation details listed in the United States role postings reflect the base salary only, and do not include possible bonus or benefits if applicable to the role.

Equal Opportunity Employer

Rivia Mind is an Equal Employment Opportunity Employer. It is the policy of Rivia Mind to provide equal employment opportunities without regard to race, color, religion, sex, gender identity or expression, pregnancy, age, national origin, weight, height, disability, marital status, veteran status, sexual orientation, genetic information, or any other protected characteristic under applicable law.

It is also the policy of Rivia Mind that qualified individuals with disabilities receive equal opportunity regarding job application procedures, hiring, and all aspects of the employment process.

Rivia Mind is committed to the full inclusion of all qualified individuals. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of Rivia Mind to provide reasonable accommodations when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship.

If reasonable accommodation is needed to participate in the job application or interview process, pre-employment testing, to otherwise participate in the selection process, to perform the essential job functions, and / or to receive other benefits and privileges of employment, please contact us directly.