Credentialing Coordinator - Health/Social Services
Inspire Diagnostics

Great entry-level opportunity exists for a Credentialing Coordinator to join an outstanding team at Aspire Health Alliance!

This position is responsible for ensuring that the agency has credentialed all clinicians and licensed all facilities and that clinicians and facilities meet all federal, state, and third-party payer requirements. Ensures appropriate staff complete primary source verification, privileging, and insurance roster/waiver applications. It is a liaison role, requiring regular interaction with all services, departments, and levels of staff within the agency, and frequent interface with external payer sources and other licensing agencies. This individual is responsible for establishing and implementing performance goals, metrics, and processes, as well as implementing process improvements as needed. Will be the resource for any issue with payers and work with intake, billing, and operations staff to resolve. Is responsible for responding to internal and external requests for information, facility and provider applications, and a variety of related projects.

• Takes responsibility for, and responds to, requests for information, applications, surveys, etc., from agency staff and/or external sources regarding licensing, credentialing, and privileging.
• Disseminates pertinent updates and advisories from payer and/or other sources in a timely manner to all relevant parties.
• Serves as liaison internally for staff regarding insurance and panel issues. Responds to questions, concerns, and problems related to payer and/or other sources arising from the clinical delivery system (clinicians and administrators), intake, and billing departments. Problem-solves billing and authorization issues in conjunction with the Director of Compliance.
• Manages all aspects of the clinical staff credentialing and privileging process.

Schedule:

Full time: Monday - Friday days (flexible hours)

Offering great benefit package!

• Tuition remission program - 100% tuition for undergraduate coursework in a Massachusetts College or University
• Health/dental insurance
• Generous paid time off
• Various opportunities for career advancement
• Commitment to provide quality training to our staff
• Group discounts on cell phones, movie tickets and various club memberships
• Company contribution to retirement plan
• Company paid life insurance
• Opportunities to attend in-service trainings and more...
  
  

About Aspire Health Alliance

Celebrating 100 years of service in 2026, Aspire Health Alliance (Aspire) is a private, non-profit behavioral health agency, providing services for children, teens, and adults experiencing serious emotional challenges, behavioral issues, and substance abuse. Our vision is there is no health without mental health. In July 2022, Aspire was designated as a Community Behavioral Health Center by the State of Massachusetts. Aspire has outpatient clinics across the South Shore in Braintree, Quincy, and Marshfield. We have services across the continuum of care including early intervention services for infants, toddlers, and their families; day treatment, intensive wrap-around services, and residential services. Bringing care to the setting where our clients most need it, we provide child and family services in the home, school, child care center, group residence, and other community settings including working with area police departments. We are committed to training the workforce of the future with training programs, internships, and graduate training opportunities.

Aspire Health Alliance recognizes that attracting and retaining exceptional staff is the key to providing excellent care for our clients. Aspire Health Alliance remains committed to the development and training of our future clinicians, staff development and community training around behavioral health.

Required Skills

• Demonstrated proficiency in using various software applications including Word, Excel and Access.
• Excellent communications skills, written and verbal.
• Excellent customer service skills.
• Excellent organizational skills and attention to detail.
• Ability to work independently.

Required Experience

• Minimum of two years working in a managed care environment, preferably behavioral healthcare, or in human resources. Prior experience with credentialing functions is preferred.
• Ability to quickly learn and understand the business of a large, complex organization.
• Ability to analyze and solve problems.
• Ability to work collaboratively with other departments of the organization, using a customer-service approach.
• Ability to be flexible and adapt to change because of industry or organizational changes.
• Demonstrated ability to carry out responsibility for projects from beginning to end.

Aspire Health Alliance is committed to and passionate about diversity, equity, and inclusion. We celebrate, support, and promote diversity of thought, culture, and backgrounds. As an employer committed to equal opportunity, we base all employment decisions on each individual's capabilities and qualifications, without regard to race, color, religious creed, national origin, ancestry, sex, sexual orientation, gender identity, age, physical or mental disability, veteran status, genetics, or any other protected characteristic. Aspire Health Alliance strives to fully reflect the clients and communities we serve and believes that a diversity of interests and cultures leads to a stronger and more innovative organization.

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