Kolmac Integrated Behavioral Health and Concerted Care Group (CCG) is a leading outpatient treatment provider in the Mid-Atlantic region. We are committed to treating individuals whose lives have been impacted by substance use and mental health disorders. We do this by providing compassionate and evidence-based treatment, aimed at improving the quality of life for those we serve. We stand behind our commitment to diversity, equity and inclusion, which are the core of our company with our patients and employees. Our leadership team invests to enhance the programs we offer patients to expand access to care and offer flexibility. Patient care is at the heart of everything we do. We want your experience and expertise on our team! When you join our team, you are connecting to a committed and caring group of colleagues.
We are currently in search of an experienced Credentialing Coordinator for our Burtonsville, MD location. The Credentialing Specialist at Kolmac Integrated Behavioral Health and all its subsidiaries ("Kolmac" or the "Company") will be required to complete the credentialing, re-credentialing process for providers and payor enrollment processes for facility contracts with insurance companies and other accrediting entities. In addition, they will maintain current data for each provider to ensure timely renewal of credentialing, licensing, and certification.
Review and process providers' initial applications and supporting documentation to identify possible issues. Follow up with healthcare provider as needed to obtain missing information
Complete and process payer enrollment applications for healthcare providers for Medicare, commercial, managed care, and other identified plans in the market
Complete timely follow-up on all payer facility enrollment applications
Maintain accurate provider profiles on CAQH, PECOS, NPPES, and in credentialing software
As directed, provide updated demographic information with supporting documents to outside stakeholders, such as commercial managed care plans and contracted billing entities
Maintain Monthly OIG checks
Ensure that re-credentialing is completed timely to prevent any lapse in enrollment
Monitor and maintain current documents (License, DEA, CDS, Exclusions, Board Certifications,)
Terminating enrollment with government and commercial payers upon resignation or termination of providers
Complete primary source verification and prepare files for committee review
Establish and maintain long-term working relationships with payors
Maintains confidentiality of provider information
Other Duties Assigned
Associates Degree or 10+ years of credentialing experience in lieu of education
Behavioral Health knowledge is a plus
Excellent verbal and written communication
Detail Oriented
Can manage workflow to meet deadlines
Able to work as part of a team and independently
Self-motivated to achieve goals
Outside the box thinkers; and excellent at problem solving
Enthusiastic about being part of an organization that recognizes your talent
Ability to maintain consistent contact with healthcare providers and insurance companies to ensure that expectations are clear and requirements are completed in a timely manner
Experience working with credentialing software
We Offer Competitive Compensation Full Benefits: Medical/Dental/Vision Life Insurance 401K Tuition Reimbursement Paid Professional Development Time Student Loan Repayment Program Paid Vacation Time And More! Kolmac Integrated Behavioral Health has been a leader in Outpatient Treatment since 1973. Patient care is at the heart of what we do. Kolmac Outpatient Recovery and Concerted Care Group (CCG) have merged to provide addiction treatment and behavioral health treatment services for individuals, families, couples, and groups. We serve communities across Maryland, DC, Virginia, Delaware, and Pennsylvania. We are still growing!
