Credentialing Specialist II in Latham, NY at Beacon Health Options

Date Posted: 1/18/2020

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Credentialing Specialist II a highly organized and compassionate professional to join our team at our Latham, NY office.  The Credentialing Specialist II is responsible for credentialing and recredentialing of behavioral health providers and facility organizations (hospitals, mental health centers, etc).The Credentialing Specialist II is responsible for collecting credentialing documentation and accurately building provider credentialing files according to contractual and NCQA standards using Beacon’s Credentialing System. The Credentialing Specialist II position requires independent business decisions to be made to complete credentialing files prior to submission to the Credentialing Committee. The Credentialing Specialist II is responsible for functions including but not limited to initial review of practitioner and facility applications, management of recredentialing files, and obtaining primary source verification for completion of credentialing and recredentialing files. The Credentialing Specialist II also acts as a resource to department team members and external departments in the day-to-day functions of the Credentialing Department.

What does a typical day look like?

  1. Credential and recredential behavioral health providers and facility organizations (hospitals, mental health centers, etc.) using Beacon’s credentialing system.
  2. Perform verbal, written and on-line primary source verification for individual and facility organizations including but not limited to, state licensure, prescribing certificates/registrations, education, training and certification verification, accreditation status and exclusion data-base checks.
  3. Perform accurate and timely data entry of all primary source verifications and select provider demographic and practice location information into Beacon’s credentialing system.
  4. Stay current with knowledge of NCQA credentialing standards.
  5. Credential and prepare credentialing and recredentialing files for regular and ongoing Medical Director and National Credentialing Committee submissions.
  6. Monitor work queue to ensure applications are processed within expected turnaround times.
  7. Guide, support and advise junior members of the team.
  8. Meet or exceed production and quality standards.
  9. Other duties as assigned.

 What you Contribute?

Education: H.S. Diploma or equivalent. Associates or Bachelor's Degree preferred (or equivalent) and/or experience commensurate with job responsibilities. 

Licensure: Certified Provider Credentialing Specialist Certification (CPCS) and/or Certified Professional Medical Services Management (CPMSM) preferred.

Knowledge, Skills & Abilities:

  • Minimum 3 years’ experience in insurance, medical, healthcare or related field required.
  • Professional demeanor, strong written and oral communication skills, strong computer skills, and the ability to learn Beacon’s internal systems.
  • Ability to learn quickly.
  • Detail-oriented, analytical, highly organized and possessing problem-solving skills.
  • Ability to manage varying job pressures, and meet deadlines and handle multiple tasks simultaneously with minimal supervision.
  • Ability to work in a production environment and meet production and quality goals.
  • Computer literacy and experience with Microsoft office programs (Outlook, Word and Excel), and internet searches. Knowledge working with fax machines, copiers and other office machines.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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