We are celebrating 13 years of continuous and dedicated community service!
Therapeutic Alliance LLC is a private mental health agency offering professional mental health counseling throughout Virginia for the past 13 years. We strive to provide culturally sensitive counseling services to children, adults and their families in several languages. Clients comprise all cultural, racial and economic backgrounds, including individuals with different sexual orientations.
The Therapeutic Alliance staff possess educational and clinical training that allows us to address mental health, substance abuse and behavioral issues using evidence-based methods. We provide extensive supervision to each and every case as a means to ensure a sound therapeutic approach. Our goal is to truly know our clients and to use this knowledge to guide, support, and motivate them as they make necessary life changes.
Therapeutic Alliance is a licensed provider of Intensive-In-Home(IIH), Mental Health Skill Buidling (MHSS) and Applied Behavioral Analysis (ABA).
We are offering:
Health Insurance
Health Saving Account
Dental Insurance
Vision Insurance
Life Insurance
Performance Bonus
Unpaid Extended Leave
Paid Time Off
Paid training time
Mileage reimbursement
Travel Time reimbursement
Phone reimbursement
Flexible Schedule
Liability insurance
Tuition Reimbursement
RBT Certification support
QMHP certification support
Staff recognition program
Competitive Salary Structure
Staff referral bonus program
Bilingual pay bonus
Job Description
The Credentialing and Support Specialist is responsible for following set of tasks and functions: credentialing of providers, contract management for payers, eligibility and insurance verification and clients cost share management.
Credentialing:
Ensures that the credentialing requirements for governmental agencies and commercial managed care insurers/networks are met and managed appropriately and timely so that providers are enrolled in and maintain active credentialing status with such entities.
Submits and follows up on credentialing to all payers and government agencies timely and accurately
Manages RBT credentialing and recredentialing process.
Manages QMHP C/A registration and tracking and follow up for eligibility and registration with state
Ensures providers credentialed with agency is maintained with current and up to date providers for all payers and contracts
Enters and maintains credentialing database
Provides reporting to Executive leadership as required complete and timely
Contracting:
Maintains managed care contract files (paper and electronic) and department databases for contracts while actively engaging in supporting department contracting and negotiation efforts as needed.
Manages contract process and submission and follow up to complete contract completion for all payers and agencies timely and complete
Ensures demographic changes and for site additions or deletions are promptly updated and reported to payors and agencies for all contract
Acts a liaison between contracted agency and TA for communication and follow up
Works with the Compliance Officer and COO to complete requested audits for the agency from all government regulatory bodies and payers.
Keeps all leadership informed of any contracted payor changes that may impact day to day operations.
Provides complete and timely reporting to executive leadership as required
Eligibility and Insurance Verification:
Ensure that clients behavioral health care benefits cover services.
Contacts a patient's insurance company to verify coverage levels and works with individuals to educate them on their benefits information.
Verifies each client's insurance Medicaid/MCO coverage monthly to make sure valid coverage is still in place
Completes appropriate client EMR forms for correct insurance and eligibility complete and timely
Communicates in timely manner all client insurances coverage, changes or issues with Site Leadership, Authorization Coordinator and Support Team
Client Cost Share management:
Determine and communicate with clients both verbally and in writing estimates of cost share for requested services using approved form.
Obtain written consent of Client and/or guardian to accept financial responsibility for payment of cost share using approved form
Complete and maintain payment arrangement forms for cost share of client prior to services beginning
Communicate timely with stakeholders as to acceptance or denial of financial responsibility
Work with Billing Manager to prepare monthly billing and collection of cost share
Maintain all records complete and timely
Notify stakeholders of any changes or issues involving payment of cost share
Role qualifications
Minimum 3 years of successful experience in similar position
Demonstrated comprehensive knowledge of behavioral health and managed care industry with specific emphasis on credentialing, contracting, and insurance verification
A broad understanding of the managed care contracting process is required and knowledge of managed care payers processes.
Ability to communicate effectively both verbally and in writing with internal and external stakeholders, providers, regulatory agencies and managed care companies in order to achieve the necessary results required in the credentialing and contracting process and support of the agency.
Highly Proficient in Office products and Google platform
Excellent customer service skills
Motivated, goal oriented, ability to work independently and as a team member, self starter, flexible, and detailed oriented. Apply to make a difference with us!
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