Credentialing Specialist

Thrive Behavioral Health is currently hiring a Credentialing Specialist to work in our Rosedale office located in Maryland. A Credentialing Specialist is responsible for ensuring that Thrive Behavioral Health LLC and staff are in compliance with relevant regulations, completing credentialing and privileging processes, and maintaining records. They are in direct contact with insurance carriers. The position requires a 40-hour work week on-site. Thrive serves patient populations to include children and adults ages 3 years and up, with clients meeting the DSM 5 criteria for mental health disorders and individuals with co-occurring psychiatric illness.

QUALIFICATIONS:

1. Knowledge of industry standards: organization, theory, principles, and research processes, accreditation and regulatory standards related to role as Credentialing Specialist.
2. Knowledge of governmental and healthcare regulations and reporting requirements.
3. Professional readiness: Issues related to self-awareness, diversity, ethics and continuing education.
4. Knowledge of PC software programs, including Microsoft Word, Excel and Outlook is preferred.
5. Effective written and oral communication skills.
6. Must be able to concentrate on work amid distractions such as noise, conversations and foot traffic.
7. Must be able to work independently with little direct supervision in an unstructured environment with multiple demands.
8. Reading and writing level that can clearly express or understand complex concepts, assessments, directions and processes or sequences of events.
9. Ability to represent the Company well in interactions both inside and outside the facility.
10. Skilled at researching, data collection, manipulation and reporting skills.
11. Must be organized, flexible, detail oriented, and able to demonstrate self-motivation and prioritization.
12. Establishes and maintains effective working relationships with individuals at all levels of the organization.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Keeps abreast of current literature and developments in the field and attend or completes required agency trainings.
2. Responsible for all aspects of credentialing and re-credentialing.
3. Builds relationships and interacts with all Staff, as needed.
4. Assists staff with the paneling process.
5. Ensures that all credentialing information (i.e. accreditation, membership, facility privileges, etc.) meets federal and state guidelines when processing applications.
6. Obtains insurance contracts and keeps copies of licenses, credentials, and related documents.
7. Notifies medical providers and other staff members of any changes to insurance contracts and answers any questions from medical providers regarding coverages.
8. Audits relevant reporting.
9. Understands and adheres to Thrive Behavioral Health compliance standards as they appear in Thrive Behavioral Health Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.
10. Stays aware of all pertinent federal, state and Thrive Behavioral Health regulation, laws, and policies as they presently exist and as they change or are modified.
11. Performs other duties and tasks required.

MINIMUM JOB REQUIRMENTS

Education, Training, and Experience Required:

1. High School diploma or equivalent or at least two (2) years work experience.
2. Two (2) years of relevant experience preferred.
3. Prefer CPR/FFA Certification.

PHYSICAL DEMANDS/WORKING CONDITIONS:

• The essential functions of this job include the following physical and intellectual demands:
  
  
  
  • Frequently sit, stand, and or walk
  • Frequently hearing, seeing and speaking
  • Regularly typing
  • Occasionally lift and/or move up to 25 pounds
  • The ability to work in a fast-paced environment with potential for stressful situations
  • Comprehends and performs job duties at a reasonable pace while using attention to detail
  • Concentrates, formulates plans, and makes decisions
  
  
  
  
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Due to the nature of the industry, working in the evenings, approximately 7:30-8:00 pm, may be expected.

*Please contact HR at recruiting@thrivebh.com for the full job description

Benefits Include but are not limited to:

• Health Insurance (M/D/V) through Blue Cross/Blue Shield
• Flexible Spending Accounts (DCFSA, Health FSA)
• 401(k) Retirement with a company match
• Company Paid Life & AD&D
• PTO, Holiday Pay, Bereavement Pay, & Jury Duty Pay
• EAP
• Laptop and/or MiFi available for loan
• AFLAC Supplemental Insurances (Life, Dependent Life, STD, LTD, Hospitalization, to name a few)

More About Thrive!

Thrive Behavioral Health provides individual, family, and school-based therapy services to adults, children and families in homes, schools, and community settings. We serve clients throughout Central Maryland. Our diverse team of clinicians take a proactive approach to treatment by meeting with clients via telehealth and in neighborhoods, homes, and schools to reduce the barriers to traditional mental health treatment. Thrive also has clinic-based programs in Rosedale, Catonsville, Millersville, Bel Air and Silver Spring.

The Thrive team is committed to the goal of maintaining a culture that supports its staff that represent a wide range of lived experiences, skills, and training. Bilingual candidates strongly encouraged to apply.

MISSION STATEMENT

The mission of Thrive Behavioral Health is to provide quality mental health services to individuals and families with a focus on reducing traditional barriers to accessing treatment and ensuring a high level of collaboration with our community partners.

We are committed to treating patients and their families with the highest regard and respect for patients to work toward reaching their highest growth potential in their therapeutic process. This is accomplished through the strict adherence to the highest ethical standards of care and policies and procedures set forth by the Maryland State Department of Health and the Joint Commission.

• Thrive Behavioral Health ensures all clients are treated with compassion, respect, and dignity regardless of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
• Thrive Behavioral Health employees are competent and responsible personnel who adhere to a strict code of professional ethics which include but are not limited to the prohibition of fraternization with patients, exploitation of patients, or any criminal behaviors.
• Thrive Behavioral Health provides clients with accurate and complete information regarding the available services including the program rules, regulations, goals and objectives of the program.
• Appropriate provision or referral to alternative treatment modalities is made at any time before, during, or after treatment if they are requested or the client's needs are out of the scope of our practice.
• Thrive Behavioral Health will ensure that discharge from treatment is conducted in accordance with Maryland COMAR and the Joint Commission standards.
• Thrive Behavioral Health adheres to both COMAR and Joint Commission environment of care standards.
• Thrive Behavioral Health will take all necessary and appropriate measures to maintain individual client records and information in a confidential and professional manner.
• Thrive Behavioral Health strives to maintain positive relations with the surrounding community and pursues every reasonable action to encourage responsible behaviors and community safety.

EEOC STATEMENT:

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60_1.4(a), 60-300.5(a) and 60-741.5 (a), prohibiting discrimination against qualified individuals based on their race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors.

MINIMUM JOB REQUIRMENTS

Education, Training, and Experience Required:

1. 
   

   High School diploma or equivalent or at least two (2) years work experience.

   
   

1. 
   

   Two (2) years of relevant experience preferred.

   
   

1. 
   

   Prefer CPR/FFA Certification.

   
   

PHYSICAL DEMANDS/WORKING CONDITIONS:

• 
  

  The essential functions of this job include the following physical and intellectual demands:

  
  

• 
  

  Frequently sit, stand, and or walk

  
  

• 
  

  Frequently hearing, seeing and speaking

  
  

• 
  

  Regularly typing

  
  

• 
  

  Occasionally lift and/or move up to 25 pounds

  
  

• 
  

  The ability to work in a fast-paced environment with potential for stressful situations

  
  

• 
  

  Comprehends and performs job duties at a reasonable pace while using attention to detail

  
  

• 
  

  Concentrates, formulates plans, and makes decisions

  
  

• 
  

  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  
  

• 
  

  Due to the nature of the industry, working in the evenings, approximately 7:30-8:00 pm, may be expected.

  
  

EEOC STATEMENT:

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60_1.4(a), 60-300.5(a) and 60-741.5 (a), prohibiting discrimination against qualified individuals based on their race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors.