Credentialing Specialist

Company: Gulfsouth Autism Center
Location: Metairie
Posted on: April 26, 2025

Job Description:

The Gulfsouth Autism Center is growing, and we are looking for career-driven individuals who are willing to commit to excellence.

Want to make an application Make sure your CV is up to date, then read the following job specs carefully before applying.

We are seeking an energetic person to work in a fast-paced environment as a Healthcare Credentialing Specialist. The ideal candidate for our unique organization is a self-starter and possesses a high level of attention to detail, and a strong aptitude for managing all aspects of the credentialing, re-credentialing, and contracting processes for providers in private practice at multiple locations. This position requires punctuality, the ability to work unsupervised, and a positive attitude. Hours are Monday - Friday 8:30 AM to 12:30 PM.

*DUTIES & RESPONSIBILITIES*
* Credential professional clinical staff - ABA Therapists, Speech Language Pathologists, and Occupational Therapists - in accordance with the policies of the State of Louisiana for off-site locations based on CMS/Medicare requirements.
* Verify that all items on the credentialing checklist are either obtained or performed, (i.e., verification of Malpractice insurance, obtaining current state licensures, etc.).
* Responsible for enrolling all providers in all applicable government and or commercial insurance plans.
* Perform all duties necessary to operate a credentialing program that supports initial appointments and reappointments: enter data and maintain accurate, current, and complete credentialing database system.
* Review provider credentialing information for accuracy, completeness, and follow-up in a timely fashion with providers, references, and other sources to obtain missing information.
* Establish and process appropriate documents requested for insurance websites and government agencies (i.e., business license, articles of incorporation, vendor references, etc.).
* Conduct initial contact with applicant and coordinate requests for required documents
* Monitor and respond to inquiries from Clinic departments and external insurance carriers regarding status of applications in credentialing
* Submit completed credentialing packages to respective insurance carriers via the determined method of submission (fax, email, US Postal, etc.)
* Provide regular, timely updates to executive team members regarding the status of new providers' credentialing process.

*REQUIREMENTS:*
* High school diploma required; associate degree or bachelor's degree preferred.
* 2-3 years of experience in Credentialing.
* Strong ethics and a high level of personal and professional integrity.
* Excellent interpersonal and communication skills, an outgoing personality, with a professional demeanor and positive attitude.
* Strong oral and written communication skills.
* Strong attention to detail, excellent organizational skills, and excellent
* Maintain confidentiality of all work information.
* Demonstrate an ability to function successfully in a team environment, as well as work independently

*Equal Employment/Anti-Discrimination*
GulfSouth Autism Center is an equal opportunity employer and does not discriminate based on Race, Color, Religion, Creed, National Origin, Ancestry, Sex, Pregnancy, Age, Sexual Orientation (including transgender status), Physical or Mental Disability, Marriage to a Co-Worker, or for anyone engaging in Protected Activity (opposing a discriminatory practice or participating in an employment discrimination proceeding). Additionally, this employer does not tolerate any employees engaging in discriminatory behavior.

*Compensation & Benefits*
GulfSouth Autism Center proudly offers a competitive compensation and paid holidays for our part-time employees.

Job Type: Part-time

Pay: From $18.50 per hour

Schedule:
* Day shift
* Monday to Friday

Work Location: In person

Keywords: Gulfsouth Autism Center, Metairie , Credentialing Specialist, Other , Metairie, Louisiana