Job Title: Billing & Credentialing Specialist

Position Summary: HopeSparks is seeking a highly motivated, assertive, and strong leader to be our next Billing & Credentialing Specialist.  The Billing & Credentialing Specialist is responsible for all aspects of professional credentialing for our Mental Health and Physical Health lines of business as well as provide billing support to the Agency’s Billing Manager and our Children’s Developmental Services Program Billing Clerk.  This person must have an impeccable organizational style and be able to successfully engage professional clinicians and insurance representatives alike.   

HopeSparks offers a healthy work environment that is not only physically modern and comfortable, but also has competent and cohesive colleagues who foster a supportive and professional atmosphere for all employees.  This is an excellent opportunity to be an effective change agent in the healing process of children and families and be a part of a unique team of compassionate individuals.

Position qualifications:

Must possess a positive attitude with a professional and respectful manner with therapy staff, local pediatricians and insurance company representatives

Must demonstrate strong verbal and written communication skills 

Must have 2 years’ experience working with an Electronic Health Records system

Must have a minimum of 2 years’ experience with credentialing as well as working with all aspect of insurance billing.  Experience billing for therapeutic services including Mental Health, Speech, Occupational and Physical Therapies preferred.   

Must be detail oriented and able to meet strict timelines

Job Responsibilities and Performance Standards for Credentialing:

Initiate the credentialing process with each therapist as needed.

Build provider files – documentation needed, procuring NPI’s as needed, keeping those files current

Fill out all insurance applications and addendums 

Assist therapists with the process, disseminate completeness of information provided

Initiate, complete, and maintain two credentialing gatekeeper provider profile sites: CAQH, and Medversant

Re-credentialing all therapist’s as specified by the various health plans

Initiate and maintain “Staff” profiles in ECHO/EHR system

Create new insurance profiles and their billing pathways in ECHO

Maintain Excel spreadsheet’s of our paneled providers to assist Intake with their process

Billing, Intake and therapist resource for insurance contract issues and questions

Communicate all credentialing updates/changes to the appropriate staff

Continual self-education and research on changing WAC’s, contracts, and licensure requirements

Job Responsibilities and Performance Standards for Billing Support:

A/R payment posting

EHR Support

Electronic claim’s support

Client account support

ProviderOne (DSHS) billing

Denied claims research

Work Aging as requested by manager

DCFS and Adoption support billing

Keep current on insurance billing changes, especially Medicaid

CDS billing support as needed.

Help with bank deposit’s as needed by manager

Benefits: Competitive salary with benefits for this full time position.

Application Process: Interested candidates should submit a letter of interest and resume to Corby Bilderback, HR Director.

HopeSparks is an Equal Opportunity Employer and does not discriminate against any persons on the basis of race, color, creed, religion, national origin, gender, sexual orientation, age, marital status, disability, or status as a veteran.