Mental Health Credentialing Coordinator - Remote

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 Department is critical in ensuring the integrity, accuracy, and compliance of professional credentials for individuals within our organization. This department is responsible for accumulating, evaluating, verifying, and maintaining the qualifications, licenses, certifications, and other credentials required for clinicians to perform their duties effectively and with clinical excellence. They oversee all license, board, and insurance renewals, attest to the accuracy of the provider CAQH database every 100 days, and follow up on the status of applications for enrolling clinicians with our payers. The ideal candidate is a dedicated and motivated professional who values integrity, attention to detail, and excellence in their work. They bring a commitment to collaboration, inclusivity, and achieving department goals with professionalism and care.

Application Window: Open until March 24th, 2025

Anticipated Start Date: May - June 2025

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

• Compliance: Adheres to all policies and procedures as outlined in the employee handbook. Understands and complies with all HIPAA rules, regulations, and company policies. Remain 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, and monthly tasks in the Company’s Credentialing 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. Request follow-up documentation as necessary. 
• Credentials Files: Contribute to maintaining credentialing files for all clinical roles. Information is placed in the files correctly and in a timely manner, 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, and 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. 

Responsibilities

• 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. 

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
• Experience working with online payers - delegated & non-delegated accounts
• Familiar with credentialing for large national, regional and government payers
• Must have proven experience with CAQH and NPPES enrollment
• Attentive to details and goal-oriented
• Strong interpersonal skills and proven ability to work in a team environment
• Ability to set, prioritize, manage and complete multiple tasks within deadlines with minimal oversight
• 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 

Comprehensive Benefits to Support Your Well-being

At Rivia Mind, we prioritize the well-being, growth, and success of our team members. Our robust benefits package is designed to provide support in every facet of your life—personal, professional, and financial.

Learn more here.

Health & Wellness:

• Medical Coverage - HDHP, PPO or PPO Buy-Up
• Health Savings Account, Flexible Spending Account, and Dependent Care Account Options
• Dental & Vision Insurance
• Whole-Body Wellness Offerings if Enrolled in one of our three Aetna Medical Plans 

Time Off & Flexibility:

• Front Loaded Paid Time Off (PTO)
• Observed Holidays & Annual Office Closure
• Bereavement Leave / Pet Bereavement Leave

Financial Wellness:

• Competitive Pay
• 401(k) Retirement Plan and employer match
• Employee Referral Program
• Transit and Parking Voluntary Benefit

Professional Development:

• Professional Development Stipend after 1st Work Anniversary
• Paid Professional Development Days after 1st Work Anniversary
• Learning & Development Resources

Additional Benefits:

• Short-Term & Long-Term Disability
• Group Life/AD&D Insurance
• Employee Assistance Program (EAP)
• Voluntary Benefits
• Quarterly Wellness Activities

We’re committed to helping you thrive in our Rivia Community. Join us and experience a workplace that values your health, happiness, and growth.

Compensation & Employment Details

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

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: 8 am to 4 pm

Interview Process: Recruiter Interview, Supervisor Interview, Executive Leader Interview

References will be required. 

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.