Credentialing Specialist

About this opportunity:

Workplace Options is proud to support our sister organisation, Behavioral Health Systems (BHS), in recruiting a Provider Relations Credentialling Specialist. This is an exciting opportunity to contribute to a growing organization, ensuring strong provider partnerships and the highest credentialling standards.

BHS operates one of the nation’s largest specialty preferred provider organizations (PPO), which is comprised of psychiatrists, psychologists, social workers, EAP providers as well as facility networks including hospitals, rehab/residential treatment centers, partial hospitalization programs and intensive outpatient programs. BHS fully credentials and panels their own network of providers.

Current Opportunity: Provider Relations Credentialing Specialist

Location: Alabama (Birmingham)

Full-time/Part-time: This is a full-time (40 hours per week) position.

What you will do:

Reporting to the Director, Credentialing, and with general responsibility to the Provider Relations division, this position is responsible for accurate and timely provider (re)credentialing support, and computerized file maintenance.

Responsibilities:

• Serve as liaison for providers in (re)credentialing process. Assist in resolving problems on a timely basis.
• Initiate (re)credentialing process upon receipt of application. Review provider and primary source responses. Refer all responses not meeting BHS credentialing criteria to Director, Credentialing.
• Perform National Practitioner Data Bank queries and internet state licensure board verifications.
• Maintain computerized provider system, including preparing data conversions for network providers, and entering current credentialing/quality assurance information.
• Verify and update provider information upon request or receipt of incorrect provider claim(s).
• Assist in preparation and set-up of Provider Relations meetings and panels.
• Prepare reports as requested.
• Attend quarterly credentialing committee meetings, as requested.
• Maintain all information in a confidential manner.
• Adhere to established policies and procedures as directed.
• Perform other related duties and special projects as directed.

Qualifications/Skills:

• High school diploma, some college preferred
• 3 years extensive data entry experience
• Minimum 60 WPM typing
• Proficiency in MS Word and Access required
• Advanced PC computer software skills (i.e., spread sheets, special programs)
• Accuracy and attention to detail
• Excellent proofreading skills
• Good organization and written communication skills
• Ability to meet deadlines/handle interruptions/problem-solve
• Cooperative attitude and self-starter
• Superior disposition and telephone communication skills
• Dependability and punctuality
• Ability to work with a minimum of supervision
• Alabama driver’s license and dependable transportation
• Provider credentialing or provider systems experience (or related provider relations experience) required

For further information about BHS please see

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