Job Description
Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through high-quality PHP (Partial Hospitalization Program) and IOP (Intensive Outpatient Program) services. As a newly launched organization, we are on a mission to redefine the behavioral health industry by delivering exceptional care, utilizing state-of-the-art facilities, and prioritizing the well-being of those we serve. At Guidelight Health, we are building a team of passionate, forward-thinking professionals who are eager to be part of this exciting journey to reshape mental health care. Join us in making a lasting impact!
Description:
Title: Sr. Credentialing & Licensure Specialist
Reports to: Head of Payer Strategy
Department/Location: Remote
FLSA Status: Exempt
Travel Requirement: Minimal
Guidelight Health provides insurance-based intermediate levels of care that are structured, transformative, personalized and accessible. Guidelight is an Equal Opportunity Employer. We're passionate about fostering an environment where everyone, irrespective of their race, gender, sexual orientation, or background, feels valued and included.
Summary:
The Sr. Credentialing & Licensure Specialist will report to the Head of Payer Strategy and will be responsible for leading the facility credentialing activity for the enterprise with all payers. Another key task will include assisting in state licensure applications. Other payer contracting support will also be needed. This role will be instrumental in helping the enterprise reach its growth goals.
Responsibilities:
• Complete credentialing applications for commercial and government payers, including Medicare and Medicaid.
• Proactively follow up with payers to track application progress and respond to payer requests and inquiries in a timely manner.
• Assist in completing facility state licensure applications.
• Assist in payer contract management process.
• Actively participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency.
• Support Head of Payer Strategy in a multitude of ways to enable expedient payer contracting.
Qualifications:
• Associate degree required; Bachelor's degree preferred.
• 3 years of full-time related professional experience.
• Direct experience in credentialing required.
• Experience in behavioral health preferred.
• Proficiency with Microsoft Office and video conferencing technologies.
• Strong interpersonal, organizational, evaluative and time management skills.
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