Job Description

This is a Remote position

About Zealie:

Zealie is a fast-growing Medical Billing Services company specializing in the Behavioral Healthcare industry. Our clients are substance use disorder treatment, addiction recovery, and mental health treatment centers that are saving lives on a daily basis. Our state of the art proprietary technology provides data analytics and revenue prediction tools to our clients to help them make strategic business decisions to grow their business. We are committed to delivering exceptional products and services to our clients and believe that our Payor Relations team plays a crucial role in achieving this mission. We are seeking motivated individuals with a desire to be a part of a winning team.

Job Summary:

Under the supervision of the Payor Relations Manager, the Payor Relations Team Lead is responsible for enrolling Zealie's clientele with the insurance companies in an effort to streamline claim processing and payment. This position entails additional responsibilities such as directly overseeing the Payor Relations Specialists, locating supporting documentation by utilizing Google spreadsheets, drives, folders and documents; and, communicating with internal and external personnel.

Responsibilities and Duties:

Supervise Payor Relations Specialists and ensure expectations are being met Assist Payor Relations Manager Assign weekly task to Payor Relations Specialists and for himself/herself Create/Update detailed process SOPs Request a National Provider Identifier ("NPI") for the customer utilizing NPPES portal Maintain Re-credentialing and Licensure expiration date for all clients and make sure the team submit documents before due dates. Negotiating in-network Contract rates. Utilize internal Google spreadsheets, drives, folders and documents to locate additional information required to complete each project Demonstrate customer service skills through effectively communicating with internal and external personnel when requesting additional information and providing updates on the status of each project Work closely with the Payor Relations Manager, Collections Director and/or Manager(s) on project deadlines Report directly to the Payor Relations Manager to routinely communicate the work progression and the completion of the project(s) Maintains confidentiality of all patient care information to assure patient rights are protected Perform additional duties as requested by Management

Qualifications and Skills:

Minimum of 4-5 years experience in the Credentialing process Minimum 2+ years of experience in BH & MH Credentialing process Extensive knowledge of In-network Contract request submission online and offline Excellent organizational skills Effective communication skills, both verbal and written via phone and email Proficiency in Google Products including Google Workspace, Google Drive, Google Sheets, Google Docs Ability to navigate various technology and software tools Multi-task using all available resources

Education and Experience:

Bachelor's degree or higher degree in any stream 4-5 years experience in the Credentialing process Minimum 2+ years of experience in Behavioral Health & Mental Health Credentialing process

(Preferred):

Extensive knowledge of Behavioral and Mental Health Credentialing and Contracting 5+ years work experience on paper in Credentialing process On Paper SME/Sr. Credentialing associate Having good experience of CA, AZ, TX, FL, NJ, CO & HI state credentialing guidelines Experience handling more than 25+ clients * Experience handling 280+ credentialing requests per week.