Trillium Family Services

There is a focus on prevention and health; organizations and systems are connected in a synergistic sanctuary community that generates: Non –violence, Growth and Change, Democracy, Emotional intelligence, social learning, Open communication, and Social Responsibility.. If so, we have an exciting opportunity to join our dedicated team in the role of Credentialing & Provider Enrollment Specialist.. The successful candidate in this role will have a bachelor's degree in a social science field (psychology, sociology, social work, public health) preferred or equivalent experience and education in related field with 1-3 years' experience working in a social services or mental healthcare position in an academic or practice setting.. Organize, facilitate, and compile the various materials needed for timely completion of provider enrollment and recredentialing with in-network commercial and Medicaid payers, and for renewal of any provider licenses, certifications, etc., as required by the various commercial and public payers.. As needed, support staff across all levels of care in obtaining an NPI number, ensuring appropriate taxonomy selection has occurred and provider information has been added to agency EHR.Collect, consolidate, and summarize specific contract feedback from members of the contract review group and communicate that feedback to the VP and Director of Business Development & Provider RelationsMaintain client tracking process in high-end services as related to agency finance reporting.

enrollment coordinator

About us: We embrace diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and views. The more inclusive we are, the better our work will be in fulfilling our mission of “Building Brighter Futures with Children and Families”. Our vision is to create safe communities where children are healthy, and every family has the opportunity for success. Families get the support they need – when and where they need it. There is a focus on prevention and health; organizations and systems are connected in a synergistic sanctuary community that generates: Non –violence, Growth and Change, Democracy, Emotional intelligence, social learning, Open communication, and Social Responsibility. Our investment in the future of each child means that the next generation of Oregonians will have the skills to contribute meaningfully through employment, community service, and raising their own healthy families. At TFS we believe that every child and family can have a brighter future, through the love we bring together we can make this possible. There is so much need for mental and emotional support at all levels of our communities. Our DEI Vision and Mission Our mission is to foster a company culture where diversity and inclusion is embedded in our core belief system. Our vision is to increase our fundamental awareness around inclusive best practices and execute plans to support an equitable environment. We will work to create an environment where every employee is considered and valued. We will resist hate, judgment, shame, and blame, focusing instead on difference, choice, compromise, and respect. We will adopt an understanding that DEI is a journey, not a destination. Through intentionality, we will meet others where they are and learn how to bring each other along. To take a behind the scenes look our programs please visit our website at https://www.trilliumfamily.org/. Are you ready to help children and families “Build a Brighter Future”? If so, we have an exciting opportunity to join our dedicated team in the role of Credentialing & Provider Enrollment Specialist. A bout the Opportunity: Main Purpose of the Credentialing & Provider Enrollment Coordinator will be to facilitate provider and agency enrollment and recredentialing processes, maintain electronic files to support these processes; maintain electronic databases as required by payers; facilitate monthly and quarterly payer reporting processes, support reconciliation processes as requested and ensure timely communication with internal stakeholders regarding provider and agency enrollment statuses; other duties may be may be assigned as needed. The successful candidate in this role will have a bachelor's degree in a social science field (psychology, sociology, social work, public health) preferred or equivalent experience and education in related field with 1-3 years' experience working in a social services or mental healthcare position in an academic or practice setting. Familiarity with Microsoft Excel, Access, and PowerPoint software applications is required. Candidate must have the ability to manage multiple tasks and project demands; strong written and verbal skills; strong interpersonal skills; superior attention to detail. Demonstrates Competency in the Following Areas:Maintain internal credentialing process for all licensed therapists and direct-care providers across all levels of care. This includes tracking all agency therapists, clinical supervisors, center supervisors, etc. for licensure status and creating and maintaining a formal credentialing file once licensure is achieved.Develop and maintain professional files for TFS contract and staff physicians, nurse practitioners and psychologists after initial hiring by HR staff, ensuring all professional licenses, certifications and documents remain up to date. Maintain internal credentialing process for these providers.Organize, facilitate, and compile the various materials needed for timely completion of provider enrollment and recredentialing with in-network commercial and Medicaid payers, and for renewal of any provider licenses, certifications, etc., as required by the various commercial and public payers. These providers include contract and staff physicians, nurse practitioners, psychologists, licensed and non-licensed therapists, and QMHAs.Organize, facilitate, and compile the various materials needed for timely completion of facility enrollment and recredentialing with in-network commercial and Medicaid payers; provide payers with renewals of any facility licenses, certifications, etc., as requested outside of the regular enrollment/credentialing period.Maintain organized electronic provider enrollment files that include current versions of all documents needed for individual enrollment and reenrollment processes.Maintain organized electronic facility enrollment files that include current versions of all documents needed for facility enrollment and recredentialing processes. Examples include organization’s tax ID and current w-9 form, current certifications, current licenses, current accreditation awards, current copy of liability insurance cover sheet, etc.Maintain various electronic databases required by TFS payers for individual provider and agency enrollment and recredentialing.Create monthly and quarterly staff reports as required by TFS payers; facilitate quarterly reconciliations as requested by payers.Maintain an electronic tracking system to ensure timely completion of the above-mentioned items.Maintain communication with individual providers and agency stakeholders regarding enrollment processes and provider approvals.Maintain auditing process for payers with whom Trillium has a delegated credentialing agreement.Maintain agency credentialing policy, conducting annual reviews of policy, and editing/updating as needed to ensure current processes and best practices are reflected.As needed, support staff across all levels of care in obtaining an NPI number, ensuring appropriate taxonomy selection has occurred and provider information has been added to agency EHR.Collect, consolidate, and summarize specific contract feedback from members of the contract review group and communicate that feedback to the VP and Director of Business Development & Provider RelationsMaintain client tracking process in high-end services as related to agency finance reporting.As requested, complete monthly and quarterly financial reports; disseminate information to members of finance, operations, and contracting teams.Maintain Trillium’s presence in OHA/Lines for Life Behavioral Health Provider Directory database, updating availability for each TFS program every week, adding new program information as needed.Effectively participate as a member of the Finance & Business Development teamS as assigned or requested.Adhere to HIPAA Privacy Policy and confidentiality guidelines in carrying out the various functions of this position.Complete all required trainings.Job Knowledge: Operates and makes decisions within established guidelines; organizational policy and procedure; federal, state, and local laws, rules, and regulations. Job involves a moderate degree of complexity in that employee deals with highly sensitive and confidential provider information and works against strict payer deadlines. Benefits Include: Competitive compensation100% company-paid comprehensive health, vision & dental insurance for full time employees working 30 or more hours per week.Employer-Paid Life Insurance, Accidental Death and Dismemberment and Long-Term Disability, and an Employee Assistance Program (EAP).Employees may purchase additional voluntary life insurance.Flexible Spending Accounts401(k) retirement plan with agency match up to 6%Generous sick leave and vacation package Application Details: Consideration of candidates will be on-going, and position may close after 3 days of original posting. If you need accommodation to review the information and/or complete the application process, please contact the Human Resources Department. We are an Equal Opportunity Employer and Service Provider and support culturally linguistically diverse governance, leadership, and workforce. Trillium Family Services is a drug-free workplace. All final applicants will be subject to a criminal record identification check pursuant to ORS 181.536.727.537 and agency policy. We are an Equal Opportunity Employer and Service Provider and support culturally linguistically diverse governance, leadership, and workforce.
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