Every child deserves the brightest future and Centria Autism Services is on a mission to help children with Autism Spectrum Disorder (ASD) have the best developmental experience possible while acquiring the skills to succeed in the world on their own terms. Too many children with ASD are untreated or undertreated and Centria is committed to reaching every child in need and their families with interventions based on the principles of Applied Behavior Analysis that meet – and exceed -- best practices. Our Optimal Outcomes Model(TM) looks at the whole-child, engages families in aspirational treatment planning and leverages team-based care to allow BCBA's to focus on clinical issues and support Centria's dedication to quality, family satisfaction and developmental outcomes. Founded in 2009, Centria now operates in 13 states and is working hard to develop approaches to sustain quality while reaching tens of thousands of children across the country; we use data-driven analytics and sophisticated software platforms to constantly evaluate our quality and performance, and develop new approaches to supporting our clients and their families on their journey.
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Centria Healthcare was founded in 2009 and grew two business lines to lead the state of Michigan. In 2014 we took on Autism and have since grown to be the largest provider in the nation. We blended an entrepreneurial spirit with a proven and effective care delivery system to create an unmatched client experience. We look for dedicated, hard-working, sharp individuals with a desire to go above and beyond. Thank you for showing interest in Centria Autism Services. Our mission as a company is "to help every child living with autism to develop, pursue, and achieve their goals and dreams through high quality ABA therapy and support"
Position Summary
This role is responsible for implementing credentialing guidelines for clinical and field-based personnel set by Centria Healthcare, Community Mental Health organizations, insurance companies, and other agencies. The Credentialing Specialist organizes, maintains, and verifies files on clinical and field-based staff, ensuring they are compliant and always available and eligible to provide client services. Additionally, they will provide a positive customer service experience to team members, including clinical, field staff and payors, by being the point of contact and assisting them with related inquiries.
Success measures include adherence to Centria policies, flawless execution of tasks, and meeting or exceeding personal qualitative and quantitative key performance indicator (KPI) metrics such as customer satisfaction, meeting targeted credentialing measures for active and on-hold team members and internal and external audits.
Duties and Responsibilities
The below reflects the essential functions considered necessary for this role and shall not be construed as a detailed description of all work requirements inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of all responsibilities and job duties.
Team Member Credentialing
Alert and enroll clinical and field staff in required training courses based on the payor, state, and federal regulations and track completion.
Review documentation for accuracy and ensure credentialing with Centria, payor, state, and federal mandates.
Track clinical and field staff credentialing and communicate to the appropriate individuals to ensure receipt before expiration.
Update internal and external systems with credentialing documents.
Communicate credentialing deadlines with the Operations Team at established milestones and escalate as needed to prevent team members from going on hold.
Perform dormant team member follow-up and offboarding tasks as needed and in credentialing with Centria guidelines.
Document and Data Integrity and Reporting
Remain current with changes in payor regulations and related operational processes.
Assist with audits from external and internal sources and ensure timely completion.
Provide documentation, status updates, and reports on clinical and field staff credentialing to other departments and leaders as needed or requested.
Customer Service
Serve as a resource for team members with questions regarding Centria guidelines, payor requirements, etc.
Follow-up via email or service desk with team members within 24 hours and maintain a customer satisfaction rating above 90%.
Education
Associates Degree
Bachelor's Degree, preferred
Work Experience
1 + years administrative or customer service experience
Data entry experience, required
Equipment and Technology Experience
Laptop or Desktop computer
G Suite (Gmail, Drive, Docs, Sheets, Google Meet)
Microsoft Office Suite (Word, Excel)
Knowledge and Skills
Proficiency in PC software, especially spreadsheet programs;
Effective communication skills, both written and verbal, with internal and external stakeholders;
Ability to build rapport with team members, including clinical and field staff, explain complicated information in an approachable and easily understood manner, effectively handle challenging phone conversations, and represent the Centria brand;
Ability to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks;
Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes;
Excellent interpersonal and listening skills;
Demonstrated strong work ethic with attention to detail, accuracy, and quality;
Established track record of generating error-free work.
Competency Requirements
An initial assessment of competency will be completed during the interview period and evaluated on an ongoing basis.
Ability to follow written instructions
Ability to use computers and computer/software programs
Communication skills
Working Conditions
Centria's office hours are Monday through Friday from 8:30 am – 6:00 pm.
Additional time or occasional shift in schedule may be required to complete the above work or meet company objectives.
Overtime is not a planned part of this role; if required, overtime must be pre-approved in writing by a leader in the department.
Physical Demands
While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a screen.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.
