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Credentialing Specialist

Ellie Mental Health - MN

Credentialing Specialist

Mendota Heights, MN
Full Time
Paid
  • Responsibilities

    Ellie Mental Health is looking for Credentialing Specialist to support our Minnesota clinician credentialing process!

    The Credentialing Specialist Level 1 is responsible for accurate completion of clinician and group payer enrollment applications, revalidations, and payer research for our Corporate Owned Minnesota based clinics. The Credentialing Specialist L1 will ensure all provider's qualifications and skills are accurate while getting them listed as an approved in-network provider by the insurance companies. Strong attention to detail is essential to this role as well as the ability to maintain a high level of production and accuracy.

    An ideal candidate for this role would have a passion for our mission and personal values that match ours. Ellie Mental Health has a goal to make getting mental health care the norm by crushing the stigmas surrounding seeking mental health care. Our mission is to compassionately transform the culture of mental health care by providing creative solutions that make wellness accessible in every community.

    Our core values emphasize impactful connections that allow us to fill the gaps in our communities and make a real difference. These values are creativity, authenticity, humor, compassion, acceptance, and determination.

    This position requires current residence in the State of Minnesota. While required to reside in Minnesota, this position is open to fully remote or hybrid work schedules.

    Primary Responsibilities:

    Submit provider credentialing for all new and existing clinical staff, including clinical psychotherapists, psychologists and medication management providers utilizing platforms such as CAQH, PECOS and MCC

    Ensure provider information remains up to date over time and submit provider re-credentialing in a timely manner

    Notify insurance companies of demographic changes for individual providers and/or group locations (e.g., adds/changes/terms)

    Electronically track individual and group information in accordance with applicable credentialing standards

    Identify the required documents needed to submit and complete applications to each insurance company

    Prioritize insurance companies and stay familiar with individual insurers' regulations

    Research and investigate payer credentialing requirements, applications, and issues that may arise during the credentialing and contracting process

    Ensure credentialing status for providers is accurately communicated to Client Access Team through Ellie Match tool

    In partnership with Senior Leadership and Finance, secure professional liability insurance for all licensed providers

    Track expiration dates for applicable licenses and insurance policies to ensure provider credentials are compliant with contract requirements

    Serve as the subject matter expert for other MN departments and be available to consult as needed

    Regularly provide support to the Franchise Credentialing Team for Ellie Match Insurance Updates and Maintenance

    Other duties as assigned

    Required Skills/Abilities:

    High School Diploma

    1+ years of Minnesota specific provider credentialing and payer enrollment experience required, Behavioral Health Preferred but not required

    1+ years of Minnesota Credentialing Collaborative experience

    Proficient in Microsoft Office, credentialing databases and other software

    Ability to work independently and collaboratively with other teams to achieve goals

    Strong communication skills, both verbally and in writing; clear, concise, and professional

    Exhibit good judgement, honesty, integrity, responsibility, and punctuality

    Ability to analyze issues and suggest or determine solutions

    Excellent organizational skills and attention to detail

    Ability to work well in a fast-paced, changing environment

    Excellent time management skills with a proven ability to meet deadlines

    Ellie Mental Health is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, sex, religion, national origin, citizenship status, age, disability, veteran or military status, sexual orientation, gender identity/expression, genetic information, or any other legally-recognized protected basis under federal, state or local laws, regulations or ordinances. Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change or adjustment to a job or work environment that will ensure an equal employment opportunity without imposing an undue hardship on the operation of the business.

    Flexible work from home options available.