Job description

Responsible for accurately and timely enrolling NARA NW providers with insurance plans and credentialing groups. The Insurance Contract Specialist will coordinate with the Credentialing Specialist to initiate enrollment of credentialed providers and review, track, and monitor approval through expiration. Ensures timely and accurate enrollment of providers and agency with various insurance plans and credentialing groups to ensure complete compliance. Responsible to research and resolve enrollment, contracting, and/ or credentialing related issues. Works with the Billing Department Staff and providers to resolve enrollment, contracting and/ or credentialing related issues.

Responsible for all aspects of the credentialing and re-credentialing for providers. Responsible for ensuring providers credentialing is current with private and public payers

ESSENTIAL JOB DUTIES:

• Process credentialing information for newly contracted Providers and Facilities.
• Maintain an up-to-date credentialing database to ensure information is current and accurate.
• Enroll practitioners with all appropriate client health plans; monitor and report on progress of each practitioner
• Use the CAQH system and other databases to submit practitioner data as required by some client health plans to credential individual practitioners
• Maintains knowledge of current health plan and agency requirements for credentialing providers.
• Ensures practice information is current with health plans, agencies and other entities.
• Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and contracting issues as they arise.

QUALIFICATIONS:

• High School Diploma or General Education Diploma required.
• Credentialing or insurance contracting experience preferred.
• Minimum of 1-year medical office billing experience.
• Experience with Oregon Medicaid, Medicare, and managed healthcare.
• Intermediate to advanced proficiency with MS Office applications.
• Highly proficient in the use of practice management software, Athena Practice preferred.
• Demonstrates a high level of accuracy and attention to detail.
• Knowledge of medical terminology.
• Skilled in basic math and knowledge of general accounting procedures.
• Proficient in data entry and management.
• Demonstrated ability to complete documentation in accordance with governmental regulations and laws, and NARA NW policies, procedures, guidelines and best practices.
• Ability to maintain professional boundaries with clients, the community, and other staff members.
• Work collaboratively with clients, other NARA staff, team members, and to always treat everyone with respect and dignity.
• Demonstrated ability to manage multiple priorities.
• Experience working within the Native American/Alaska Native community is considered a plus.
• If in recovery, must have a minimum of two years sobriety/clean time.
• Ability to pass a pre-employment or for cause drug tests.
• Ability to pass criminal background and DMV checks.

Our agency follows federal guidelines for Controlled Substances in accordance (Title 5, Code of Federal Regulations, part 731 (5 C.F.R. part 731). All employees are required to pass a pre-employment background check and pre-employment drug test.

NARA NW is fully committed to supporting sobriety. All employees must agree to model sobriety, both on and off the job, including no alcohol drinking, no illicit drug use, no marijuana use, and no prescription drug abuse behavior. If in recovery, must have been sober/clean for a length of time sufficient to demonstrate that will be able to model sobriety.

EEO/AA Employer/Vets/Disabled/Race/Ethnicity/Gender/Age. Within scope of Indian Preference, all candidates receive equal consideration. Preference in hiring is given to qualified Native Americans in accordance w/the Indian Preference Act (Title 25, US Code, Section 472 &473).

COVID-19 considerations: The Native American Rehabilitation Association of the Northwest, Inc. (NARA) now requires that anyone working for NARA be fully vaccinated from COVID-19.

Job Type: Full-time

Pay: $25.00 - $28.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Parental leave
• Referral program
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday
• Weekend availability

COVID-19 considerations:
All Employee Must be Covid-19 Vaccinated and show proof

Ability to commute/relocate:

• Portland, OR: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Computer skills: 1 year (Preferred)

Work Location: One location

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