Senior Credentialing Specialist

Description

About the Role

Mindpath Health exists to increase access to mental health care that helps people thrive. We do this by empowering our clinicians, investing in our people, and caring for the communities we serve.

The Senior Credentialing Specialist is responsible for onboarding Mindpath Health’s practitioners as it relates to required credentialing documentation and completion of delegated file review.  This position also has expert knowledge in Medicare & Medicaid and is assigned complex related tasks related to government oversight. This position is cross trained in credentialing and enrollment functions.

This is a remote, full-time role, 40 hours per week Monday through Friday.

Responsibilities

• Serves as the subject matter expert in Medicare & Medicaid regulatory standards and provides guidance to team members
• Serves as a liaison between providers, payers and internal departments to resolve Medicare and Medicaid credentialing issues
• Oversees the Medicare and Medicaid revalidation process for Mindpath providers and locations
• Stays abreast of changing state regulatory requirements and researches new state requirements when applicable
• Manages the end-to-end onboarding process, ensuring timely completion of all required documentation
• Coordinates with internal teams to facilitate a smooth onboarding experience
• Work closely with practitioners and Mindpath Health’s clinical team to address any discrepancies or missing information.
• Manages New practitioner database set up including demographics, onboarding tracking, PSV queries and payor contracting linkages.
• Performs NCQA delegation file review on all new practitioners including CAQH completion, license verifications, malpractice insurance, NPDB & other required PSV’s.
• Manages the recredentialing process for Mindpath Health’s practitioners
• Manages the Supervising Physician process for NP’s and PA’s.
• Assists with delegated payor audits
• Enters treatment form information into the credentialing database
• Assists in preparing reports and maintaining accurate records related to credentialing and onboarding statues
• Assists with payor enrollments
• Assists with Medicare & Medicaid revalidations
• Manage independent projects as needed
• Identify areas of process improvement and contribute to the development of more efficient workflows.

Qualifications

• High School degree or equivalent
• 5+ years of experience in credentialing
• Previous experience in healthcare credentialing and practitioner onboarding
• Proven experience working and complying with Medicare and Medicaid enrollment process
• Strong attention to detail and excellent organization & time management skills
• Ability to analyze, interpret, and summarize datasets
• Proficient in Excel, specifically using pivot tables & V look ups
• Excellent communication skills, written and verbal, with strong emphasis on customer service
• Experience with process improvements and ability to implement enhancements

The Benefits
We offer a robust benefits package to include:

• Medical, Dental, Vision, and EAP
• LTD/Life Insurance
• 401k with employer match
• PTO accrual starting at 15 days per year
• Paid Parental Leave
• Tuition Reimbursement Program

About Mindpath Health

Mindpath Health exists to increase access to mental health care that helps people thrive. We do this by empowering our clinicians, investing in our people, and caring for the communities we serve. As a national leader in mental health services, we are reimagining care delivery, reaching patients and focus on clinical excellence. With a team of more than 500 mental health clinicians, Mindpath Health provides a broad spectrum of psychiatry, interventional psychiatry (including TMS and esketamine) and psychotherapy care.

At Mindpath Health, we offer telehealth and in-person visits and coordinate care with primary care physicians and referring providers to ensure a focus on the total health. Mindpath Health is in-network with most major health insurance providers and has more than 80 locations across California, North Carolina, South Carolina, Florida, Texas, Arizona, and growing.

Join our community and discover how rewarding work can be!

Mindpath Health is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, ancestry, age, disability, veteran status, or any other status legally protected by federal, state, or local law.