[Hiring] Credentialing Coordinator @Lucet

Role Description

Responsible for credentialing behavioral health providers (clinicians and facilities) for inclusion in the Lucet provider network. This position will work collaboratively with providers, external agencies, and other team members within Network Operations and management staff to promote timely processing no matter how complex the credentialing issues.

Provider Credentialing & Verification

• Research and verify provider credentials, including licensure, education, insurance coverage, and professional background through phone, email, and fax correspondence.
• Communicate with external agencies and conduct database searches to validate provider qualifications and background status.

Application Review & Data Management

• Review provider applications for errors, gaps in employment or insurance coverage, and inconsistencies; follow up to obtain required information and ensure complete submissions.
• Maintain accurate provider records by entering and updating information in credentialing databases, ensuring data integrity and compliance standards.

Credentialing Operations & Process Improvement

• Prepare and update provider files for presentation to Credentialing Committee and Clean File Committee meetings.
• Support departmental projects and identify opportunities to improve credentialing workflows, efficiency, and overall process effectiveness.

Qualifications

• High school diploma and 2 years health related experience or education
• Exceptional customer service skills
• Excellent verbal, written, and oral communication skills
• Ability to troubleshoot issues and problem solve
• Strong computer and Microsoft suite skills specifically Excel
• Ability to pass background check upon hire and throughout employment

Requirements

• Someone who embodies our values by:
• Serving everyone with compassion and leading with empathy.
• Stepping up and creating value by taking charge and acting when there is an opportunity.
• Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
• Nurturing growth and belonging by respecting and celebrating everyone for who they are.
• Ability to work well collaboratively; conscientious and positive.
• High detail-orientation and document editing ability.
• Pride of work and accountability.
• Ability to meet deadlines and communicate issues in order to quickly resolve.
• Intuitive nature to identify compliance irregularities.
• Excellent communication and interpersonal skills, with the ability to collaborate across teams.

Working Conditions

• High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds required.
• Frequent use of computer and phone systems.
• Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• Work is performed from home with company-provided equipment.
• A quiet workspace with minimal background noise for calls.