Credentialing Specialist

Wauwatosa, WI, USA Req #65
Tuesday, May 24, 2022

Interested in joining Milwaukee County? Milwaukee County is searching for authentic people who are out to change the game and bring their whole selves to work every day.

 

Milwaukee County oversees operations from our Airport, Behavioral Health, Child Support Enforcement, Combined Court Operations, Sheriffs Department, House of Corrections, Human Services, Parks, Public Safety, Public Works, Fleet Operations, Transportation, and at the Zoo. Our departments are also dedicated to our Seniors in the Department on Aging, those with Disabilities, and Veterans Affairs. Our employees also remain committed to serve the cultural, human, recreational and social needs of the entire community.

Milwaukee County offers a wide variety of interesting jobs for people who want to make a difference in our community. Milwaukee County provides a competitive benefit package and is an Equal Opportunity Employer.  If disability related accommodations are needed, please contact 414-278-3936.
 

Come and join our team and discover our diverse and versatile community of independent spirits and unique talents, we are redefining the way you think about Milwaukee County!

 Behavioral Health Division
 Hourly Range $17.91 - $25.07
 
This posting will close on 6/7/2022 @ 11:59 pm CST, or earlier upon receipt of the first 50 application submissions.

Job Summary: Under the direction of the Contracts and Network Services Manager the Credentialing Specialist ensures all providers in the Community Access to Recovery Services (CARS) Provider Network meet all the credentialing and onboarding/impaneling requirements as well as the program qualifications required to provide direct and or indirect services to consumers in the CARS programs. This positions reviews, analyzes, and processes provider applications, certificate of insurances, staff add/drop requests, and requests to be credentialed.

 

Job Duties:

  • Ensure all components are submitted and complete.  Process and reviewing applications, staff add/drops, background checks, insurance certificates, credentials, DOJ/DHS letters, etc. Process applications and review/finalize paperwork related to determination of eligibility.
  • Process and review Universal Applications to credential new AODA and Behavioral Health providers.  Review all relevant requirements (e.g. licenses, NPI# and MA certification verification, OIG status, etc.). Prepare correspondence for eligibility determination, and/or incomplete applications and documents.  
  • Update vendor or individual provider related information in Software Application; including adding or deleting providers from network or modification of services for approved providers. Update resource guides, contract entries, as well as maintain up-to-date service descriptions and updated reimbursement rates as needed.
  • Respond to provider questions about various aspects of the provider network and application process; process and log completed applications in Avatar and Staff Roster; prepare correspondence for eligibility determination, and/or incomplete applications.
  • Prepare and update presentation materials and handouts for orientation classes. Assist with the preparation of new, renewal, etc. agreements. Schedule in-service for vendors to review updates and policy changes, etc. Prepare packets for vendors and make copies of materials, etc.      
  • Maintain processes which support the BHD network for Community Vendors by testing and troubleshooting network problems and concerns. Analyze network adequacy and utilization throughout provision of services; collecting feedback from programmatic staff regarding potential network shortages.
  • Support Contract Administration Department with operations by working on special projects to identify or support the departments efficient operations daily.
  • Manage the provider and credentialing shared mailboxes; maintain minutes/notes for Provider Network and Credentialing Committee meetings; assist with questions from vendors on AVATAR, and handle BHD Fiscal requests related to AVATAR and billing issues.
  • Perform all other duties as assigned.

Minimum Required Qualifications:

  • This position requires you to have completed the vaccination against COVID-19 and provide proof of a completed vaccination as a condition of employment or submit a completed medical or religious exemption and accommodation request form.
  • Current resident of the State of Wisconsin
  • Current Wisconsin Driver's License maintained throughout employment
  • A bachelor’s degree or higher from an accredited institution AND at least one (1) year of recent experience working in a Credentialing or Quality Assurance support role is required
  • In lieu of the bachelor’s degree, at least a high school (GED equivalent) and FIVE (5) total years of recent experience working in a Credentialing or Quality Assurance support role is required
  • Proficiency in Microsoft Office Software specifically Excel and Access
  • Demonstrated excellent customer service skills

Preferred Qualifications:

  • Avatar and Staff Roster software experience
  • Formal Administrative or Executive Assistant training and/or certification.
  • Familiarity with contracting or provider network environment
  • Knowledge of Social Services or Behavioral Healthcare
  • Ability to work in an environment quickly changing demands

Additional Knowledge, Skills and Abilities:  Knowledge of Federal, State, and local laws governing Milwaukee County contracts; oral and written communication skills; ability to write reports; skill in database management, word processing and spreadsheet software applications; research skills; organizational skills; ability to work effectively and harmoniously with vendors, county staff, and other governmental agencies, and ability to lift/carry/push/pull up to 10 lbs. occasionally.

NOTE: This ORIGINAL APPLICATION is open to all qualified residents of the State of Wisconsin. Candidates need to submit a full account of their training and experience (i.e., by submitting an up-to-date resume or by fully completing an application) during this application process and may also be asked to take a written or performance tests as part of the selection process.


APPLICANTS MUST POSSESS MINIMUM QUALIFICATIONS AT TIME OF FILING APPLICATION

Milwaukee County is committed to fostering an equitable working environment, free from discrimination and harassment, on the basis of any characteristic protected by law. We prohibit any form of discrimination, harassment based on race, color, religion, sex, gender, gender identity or expression, sexual orientation, pregnancy, pregnancy related condition, national origin, age, disability, FMLA status, sexual orientation, military status, marital status, or any other category or status that is now or in the future protected by federal, state, and local law. We maintain a drug-free workplace and perform pre-employment substance abuse testing, background checks and pre-employment physicals subject to job requirements. If special accommodations are needed, please contact 414-278-3936.

Effective October 1, 2021, Milwaukee County will require all employees to have completed COVID-19 vaccinations and provide proof of vaccination or have submitted a completed medical or religious exemption and accommodation request. All persons offered a position will be required to provide proof of completed COVID-19 vaccination at time of hire or have submitted a completed medical or religious exemption and accommodation request and been approved for an accommodation prior to hire.

Other details

  • Job Family 15 - Other
  • Job Function 6 Administrative Support
  • Pay Type Hourly
  • Min Hiring Rate $17.91
  • Max Hiring Rate $25.07
  • Travel Required No
  • Required Education High School
This posting is inactive.
Location on Google Maps
  • Wauwatosa, WI, USA