Insurance Credentialing Specialist - Gilbert, United States - Lighthouse Psychiatry Brain Health Center

Lighthouse Psychiatry Brain Health Center Gilbert, United States

1 week ago

Full time

Description

About the Job:
We are a growing mental and behavioral health company based in Arizona's East Valley that is currently looking for qualified individuals to join our growing team. Lighthouse offers a positive and healthy work environment with opportunities to learn new clinical modalities, professional development opportunities, career advancement within the company, and be part of a healthy work environment. The Company:
Lighthouse Psychiatry (and its affiliate nonprofit Lighthouse Wellhealth) is dedicated to providing a patient-centric and quality-focused experience. Through a personalized approach to care delivery, we offer a customized treatment solution specifically tailored to the needs and challenges of the individual. Our patients have the benefit of utilizing a diverse collection of services including psychiatric medication management, specialized counseling (trauma, individual, couples, family, group), advanced TMS, Spravato (nasal esketamine), IV ketamine, ADHD testing and treatment, pharmacogenetics testing and evaluation, and photobiomodulation. Our goal is to provide a comprehensive and synergistic approach to patient care to maximize outcome and success. We approach patient care with the mindset that no two individuals are the same, hence no two treatment plan should be the same. Our nonprofit affiliate Lighthouse Wellhealth is dedicated to providing mental health services for kids at schools. Company Culture is like no other:We pride ourselves on our values. Our core values are rooted in Wellness, Empathy, Collaboration, Compassion, Commitment, Appreciation, Respect, and Empowerment (WE C3ARE). We strive to achieve and implement those properties to each and every patient who allows us to be a part of their care. We equally strive to extend those characteristics to our current and future team members. We strongly believe in a healthy work-life balance to ensure a positive emotional and mental wellbeing for everyone who commits to working at Lighthouse Psychiatry and the people and community we serve. Company Mission Statement:
Guided by our passion for our profession and our commitment to healing, we offer effective interventions to improve the emotional and mental well-being of patients. Through innovation and technology, we aim to decrease the stigma of mental illness, assist in the recovery and growth of individuals. At our core, we strive to continuously invest in people.
Job Description:The insurance credentialing specialist is responsible for overseeing the credentialing process for our clinicians. Their duties include, but are not limited to, drafting and submitting applications, communicating with the insurance company to expedite the credentialing application process, negotiating higher reimbursement rates, updating CAQH, submitting supporting documents, and maintaining organization in the application process.

Minimum Qualifications:

Some college or trade school education (in relevant field)
Certification in Medical Billing Services
Certification in Medical Coding (Preferred)
Two or more years of experience with credentialing
Working knowledge of the credentialing process
Working knowledge of different insurance credentialing requirements and procedure
Two or more years of relevant experience in the medical environment and facility
Two or more years of work experience in the field of mental health, behavioral health, or psychiatric care
Physically able to perform typing tasks on a computer, walk, stand, stoop, and bend
Possess interpersonal skills to work in a team structure
Strong communication skills
Proficient in English (oral and written)

Experience:

Experience with working insurance company provider relations and navigating credentialing process
Experience in multitasking and prioritizing responsibilities in a work environment
Experience with attention to detail and problem-solving in a work environment
Strong written, verbal, in-person, and telephonic communication skills
Experience working with patients in a medical or clinic environment
Experience working with mental health patients, experience working alongside mental health professionals
Strong organizational and planning skills
Ability to effectively work, communicate, support, and accepting of individuals of all backgrounds
Ability to work accurately, efficiently, and productively based on metric-based evaluations and assessments
Ability to maintain positive office etiquette
Ability to work effectively under pressure
Possess a warm and welcoming personality
Maintain positive and constructive rapport with staff, providers, clients, and patients
Experience in establishing professional and emotional boundaries with patients and clients
Strong computational skills using PC and Mac computers
Strong understanding of Microsoft office software

Responsibilities:

Check and respond to voicemail, phone, text, and email messages promptly
Check and respond to internal office messages (ie. Slack), email, text, and phone messages promptly
Answer phone calls promptly and courteously, maintaining professionalism at all times
Utilize software to identify outstanding accounts
Minimize operator error with frequent re-check of work. Must report the error to supervisor/manager immediately
Generate statements and invoices to patients and clients
Process all payments using payment services
Reconcile all payments with each account
Send delinquent accounts to management
Regularly review billing and accounting data for accuracy
Verify patient insurance eligibility and benefits
Obtain referrals and authorizations from insurance companies for procedures and follow up visits
Follow up on unpaid and denied claims and submit appeals, when applicable
Audit all payment, accounting, and account inconsistencies or errors
Collaborate with patients, insurance companies, and other team members to resolve billing inconsistencies
Inform patients of any missed or upcoming payment deadlines
Input payment history or financial data into an individual account
Input detailed notes in EMR or any software
Collect fees and record information
Scan all pertinent documents into patient charts (such as medical records, medical records requests, EOBs, claims, etc)
Check faxes: download to patient chart if needed and respond to them, fax inquiry appropriately
Document control: Scan/Fax documents/paperwork into patient charts
Follow up with client's admin staff needs regarding billing concerns
Provide new and ongoing training supports to new and existing staff members, especially for quality assurance purposes
Provide new and ongoing training supports, under the direction of supervisor/manager, to new and existing externs for educational purposes
Contribute to a positive work environment and positive rapport with patients, staff, and providers
Be professional and courteous when engaging and communicating with patients, clients, and visitors
Maintain a high degree of accuracy regarding all details
Meet and coordinate with management to discuss workflow/procedures
Respect and maintain strict privacy and dignity of patients: assure patient confidentiality at all times (HIPAA)
Prepare and present reports to management
Perform other duties or follow up relevant to assigned project duties and responsibilities
Participate in ongoing staff and educational training and quality assurance and employee development processes

The Pay (variable):

The pay rate is negotiable and based on past experience, adaptability, and official certification(s).

The Location:

Interview will take place at our Gilbert, AZ office.

Why Should You Apply?

Joining our team is joining a mission to make a meaning difference in people's lives, to advocate for mental wellness, and to make a purposeful impact in our community. We are committed to being the difference to make a difference.
This is an opportunity to work with a group of passionate, caring, and supportive professionals.
Staff work-life balance is a priority.
Opportunities for on-the-job training.
Opportunities for career growth within the company over time-based on availability and need.
Work in an environment that fosters personal growth.
In general, no weekend duties/responsibilities.

Ready to apply?
Please submit your resume and cover letter.
We look forward to meeting you

About Lighthouse Psychiatry Brain Health Center:

Lighthouse Psychiatry (and its affiliate nonprofit Lighthouse Wellhealth) is dedicated to providing a patient-centric and quality-focused experience. Through a personalized approach to care delivery, we offer a customized treatment solution specifically tailored to the needs and challenges of the individual. Our patients have the benefit of utilizing a diverse collection of services including psychiatric medication management, specialized counseling (trauma, individual, couples, family, group), advanced TMS, Spravato (nasal esketamine), IV ketamine, ADHD testing and treatment, pharmacogenetics testing and evaluation, and photobiomodulation. Our goal is to provide a comprehensive and synergistic approach to patient care to maximize outcome and success. We approach patient care with the mindset that no two individuals are the same, hence no two treatment plan should be the same.

Medical Credentialing Specialists

1 week ago

Community Bridges, INC Mesa, United States

'''Duties:''' · - Verify and validate provider credentials, including education, training, licensure, and certifications · - Ensure compliance with regulatory standards and accreditation requirements · - Maintain accurate and up-to-date provider information in the credentialing d ...
Credentialing Specialist

2 days ago

iCare Health Services LLC Glendale, United States

**Credentialing Specialist** · **About us** · iCare Health Services LLC is a healthcare company providing quality life-enhancing services to individuals and families in the State of Arizona since 2016. iCHS offers a unique combination of premier services such as day programs, beh ...
Credentialing Specialist

1 week ago

Native Health Phoenix, United States

Company Description · At NATIVE HEALTH, we strive to provide the best health care available for urban American Indians, Alaska Natives, and other individuals who generally experience barriers to health and wellness services. · Mission: To provide accessible holistic patient ce ...
Credentialing Specialist

4 days ago

NATIVE HEALTH Phoenix, United States

Job Description · Job DescriptionCompany Description · At NATIVE HEALTH, we strive to provide the best health care available for urban American Indians, Alaska Natives, and other individuals who generally experience barriers to health and wellness services. · Mission: To provide ...
Credentialing Specialist

6 days ago

Vivo HealthStaff Phoenix, United States

Job Description · Job DescriptionThe Credentialing & Patient Access Specialist is responsible for successfully completing initial and subsequent credentialing of primary care providers (PCPs) with health insurers and Independent Physician Associations (IPAs) as required, respondi ...
Dental Insurance Credential Specialist/fee Schedule

2 days ago

American Dental Companies Phoenix, United States

We are a Patient and Team Focused Private Dental Practice looking for a great individual to join our excellent team. · We pay at the top end of the profession and provide medical, dental, PTO, paid vacations, and additional training and guidance to help our team members reach the ...
Credentialing Specialist/ Contract Reviewer

5 days ago

Southwest Network Phoenix, United States

Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical practitioners providing member care at Southwest Network. Ensures practitioners are credentialed, affiliated and approved with health plans and all appropriate sites. Main ...
Dental Insurance Credential Specialist/Fee Schedule

1 week ago

American Dental Companies Phoenix, United States

We are a Patient and Team Focused Private Dental Practice looking for a great individual to join our excellent team. · We pay at the top end of the profession and provide medical, dental, PTO, paid vacations and additional training and guidance to help our team members reach thei ...
Strength & Conditioning Coach

1 week ago

OrthoArizona Chandler, United States

**Strength & Conditioning Coach - Hockey Specialism** · OrthoArizona is seeking to become the leader in the field of comprehensive Musculo-skeletal training and treatment provision for athletes and Youth Sports. With multiple facilities distributed across the Greater Phoenix regi ...
Medical Assistant

1 week ago

Concentra Mesa, United States Full time

Overview: · Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process. · We're in the amazing position for a future filled ...
Rehabilitation Specialist

1 week ago

Copa Health Mesa, United States

**Compensation: $21 - $23 hourly** · **What You'll Get** · When you join our team as a full-time Rehabilitation Specialist, you'll receive: · - 9 paid holidays per year and paid time off accrual- Access to health coach and wellness incentives- Tuition reimbursement up to $3,000- ...
Clinical Education Specialist

2 days ago

AMR Mesa, United States

More Information about this Job: · **JOB SUMMARY** · Under general direction, oversees Clinical and Education Services activities for the local service area. Represents GMR to local committees, medical and training institutions, and other related agencies. Responsible for the cre ...
Peer Recovery Support Specialist

1 week ago

Sage Counseling Inc Tempe, United States

**_Looking to make an impact with those involved in the Criminal Justice system? Join SAGE Counseling_** Our treatment programs were developed for criminal offenders. Our overall clinical approach is grounded in the evidence-based standards for these populations. SAGE is a dynami ...
Research Specialist, Histology

2 days ago

Arizona State University Tempe, United States

The Biosciences Histology Core at Arizona State University in Tempe Az, is looking to hire a **Histology Research Specialist**. The Histology Core is one of thirty facilities within Knowledge Enterprise. The Histology Core location in ISBT1 is located in conjunction with the Flow ...
Credentialing Clerk

14 hours ago

Old Town Scottsdale Surgery Center Scottsdale, United States

**Job Summary**: · We are seeking a detail-oriented and organized individual to join our team as a Credentialing Clerk. As a Clerk, you will play a crucial role in maintaining accurate medical staff records and providing administrative support to our medical staff services office ...
Childcare Provider 2-prek

4 days ago

Scottsdale USD 48 Scottsdale, United States Part time

**PAY GRADE**:F · **FLSA STATUS**:Non-Exempt · **POSITION OBJECTIVE**: · The job Childcare Provider 2 is done for the purposes of assisting the Childcare Specialist with the planning of the before and after school program and supervision of children. · **DUTIES & RESPONSIBILITIES ...
Industrial Hygienist Program Manager

4 days ago

Western Technologies, Inc. Scottsdale, United States

**Western Technologies Inc.** · **Industrial Hygienist Program Manager** · Western Technologies Inc., one of the RMA Companies, has an excellent opportunity for an Industrial Hygienist Program Manager in our Phoenix, Arizona office. · **Key Responsibilities** · - Companywide resp ...
Echo Tech

3 days ago

HonorHealth Phoenix, United States

Overview: Looking to be part of something more meaningful? At HonorHealth, you'll be part of a team, creating a multi-dimensional care experience for our patients. You'll have opportunities to make a difference. From our Ambassador Movement to our robust training and development ...
Referral Specialist Urology Clinic

2 days ago

Banner Health Phoenix, United States

**Primary City/State**: · Phoenix, Arizona · **Department Name**: · C/P-Urology-Clinic · **Work Shift**: · Day · **Job Category**: · Administrative Services · At Banner - University Medical Group (BUMG), we're creating a world class medical organization that brings together a lea ...
Cognitive Performance Specialist

14 hours ago

LMR Technical Group Glendale, United States

LMR Technical Group (LMR) is seeking a Cognitive Performance Specialist to join our team. · **Location**: Luke AFB, AZ · **Background**: · The Comprehensive Readiness for Aircrew Flying Training (CRAFT) initiative, launched in 2020 by the Air Education and Training Command (AETC) ...