Credentialing Associate

We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth.

Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touching the lives of more than 30,000 patients daily.

Our mission is to remove all barriers to recovery and transform individuals, families, and communities with treatment that works.

Our employees believe we are creating a better world where lives and communities are made whole again through comprehensive treatment.

The Credentialing Associate will facilitate all aspects of payor credentialing. Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for providers and facilities for assigned states. The Credentialing Associate will have a good understanding of all credentialing functions across all states that Pinnacle operates in. This position will also assist with monthly provider license verifications for all licensed providers.

Responsibilities:

• Maintain data entry of all new and updated provider/facility information into Credentialing System. This would include new hires, rehires, terminations, changes,
  moves, etc.
• Complete all individual and facility credentialing and recredentialing applications as needed. This will include updating rosters and portals. This also includes
  maintaining individual and facility credentialing documents needed for applications.
• Updating and monitoring of State Medicaid Portals. This includes facilities/individuals for both initial and revalidations.
• Complete all payor directory updates in a timely manner.
• Maintain, validate and audit Credentialing System for updates and missing information for providers and facilities. Work with Credentialing Team on audits as needed.
• Monitor, verify and maintain all provider license records. Assist with monthly license verification reports and Credentialing System for any flags/errors.
• Complete Individual and Facility Delegated Credentialing Process for review by the Delegated Credentialing Committee.
• Other duties as assigned.

Requirements:

• Comply with organizational policies, procedures, performance improvement initiatives and maintain organizational and industry policies regarding confidentiality.
• Adhere to all applicable HIPAA (Health Insurance Portability and Accountability Act) and 42 CFR Part 2 guidelines to ensure confidentiality of patient information.
• Knowledge of legal policies and regulations in the healthcare industry.
• Commitment to valuing diversity and contributing to an inclusive working and learning environment.
• Ability to partner with internal/external stakeholders, government officials, and industry associations.
• Strong organizational and time management skills and the ability to prioritize responsibilities.
• Working knowledge of Microsoft Office Applications.
• Ability to work in a fast-paced, rapidly changing growth environment.
• Excellent data entry skills.
• Ability to analyze, interpret and draw inferences from research findings and prepare reports.
• Knowledge of medical providers and facility credentialing documentation is essential.

Required education and experience:

• High School Diploma
• Two (2) years of provider/facility credentialing experience including working with Credentialing Software
• Experience with Credential Stream/HealthStream (preferred)
• Experience in Substance Abuse Treatment Facility and Provider Credentialing (preferred)

Benefits:

• 18 days PTO (Paid Time Off) + 8 paid holidays
• 401k with company match
• Company sponsored ongoing training and certification opportunities.
• Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance.
• Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP)
• Discounted tuition and scholarships through Capella University

Join our team. Join our mission.

Experience

• 2 year(s): Credentialing experience

Education

• High School/GED or better

Pinnacle Treatment Centers is an equal employment opportunity employer and makes employment decisions based on merit and other legitimate business considerations. We want to have the best available persons in every job. Company policy prohibits unlawful discrimination based on race, traits historically associated with race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), parental leave, national origin, gender, gender identity, gender expression, age, ancestry, physical or mental disability, military and veteran status, marital status, sexual orientation, genetic characteristics or information, political affiliation, non-merit based factors or any other consideration made unlawful by applicable federal, state, or local laws. It also prohibits discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.