Credentialing and Authorization Specialist Rhinebeck, NY (http://maps.google.com/maps?q=6339+Mill+Streeet+Rhinebeck+NY+USA+12572) Job Type Full-time Description Summary: The Credentialing and Authorization Specialist is responsible for obtaining insurance credentialing contracts and payer authorizations as needed. The ideal candidate will have experience working with insurances and strong organizational skills. Responsibilities: + Ensures contracts are up to date through weekly communication with contracts and credentialing personnel for all insurance payers (Managed Care Organizations and Commercial Insurance). + Identifies out of network insurance organizations for Director of Billing & RCM to review and provide contractual recommendations. + Acts as a liaison between MCOs and Astor Services for Children & Families and updates MCL and Credentialing Supervisor & Director of Billing & RCM regularly and as directed. + Facilitates and organizes conference calls where needed and recommended by the MCL and Credentialing Supervisor, Director of Billing & RCM, Managed Care Liaison and MCOs if outside the scope of credentialing process. + Maintains and updates Astor location list to fulfill insurance credentialing requirements. + Maintains and updates Astor clinician employee list to fulfill insurance credentialing requirements. + Works closely with Human Resources to maintain CAQH Proview as it pertains to all credentialing related needs and requirements. + Liaises between Insurance Provider Relations and Director of Billing & RCM to process mid to large scale claim reviews, corrections and appeals. + Monitors adherence to client payment contracts escalating to Director of Billing & RCM as needed. + Oversees Partial Hospitalization process for South Ave., working closely with the Clinical Team to coordinate exchange needed for timely execution of insurance driven requirements. + Identifies and communicates any Payer Billing changes to the Billing Supervisor (including change in status, Payer ID changes, timely filing, etc). + Works closely with the Director of Billing & RCM and Billing Supervisor to organize and arrange Scheduled calls with Provider Relations reps as needed. Job Benefits: Benefits for Full Time employees: · 4 weeks paid vacation annually; · 13 paid holidays, 4 personal days; · 1 sick day per month, accruable to 150 days; · Fully paid individual LTD and life insurance; · Eligible for participation in agency medical and dental plan both individual and family, with small employee contribution. Requirements · Associate’s degree in medical coding, finance, accounting, or related field preferred. · Minimum of 2 years direct experience with complex medical billing and collections, preferably in a managed care setting. · Strong problem solving skills. Salary Description $41,386.80-$ 44,317/yr