Credentialing and Data Specialist
Beacon Health Strategies, LLC - Woburn, MA

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This position’s main function is to credential and re-credential behavioral health providers in Beacon’s network spanning multiple states and regions. The position will perform specified assignments relating to ensuring that processes and protocols are in place to ensure all credentialing file accuracy according to contractual and NCQA standards

Responsibilities:

  • Credentials and recredentials behavioral health providers using Beacon’s proprietary FlexCare system;

  • Organizes and maintains credentialing files;

  • Works with Network Operations and other Beacon staff to ensure follow up with providers when applications are incomplete

  • Performs Primary Source Verification for individual credentialing & confirmation of facility accreditation and licensure

  • Maintains credentialing management documents

  • Tracking of all credentialed providers for the purpose of re credentialing

  • Accurately enter information into Beacon’s system of record

  • Monitor and participate in site visit and provider scores

  • Knowledge of NCQA credentialing and re credentialing standards

  • Assists with the revisions and/or development of policies and procedures

  • Prepares files for at least a quarterly Credentialing Committee;

  • Assists with the coordination of Credentialing Committee

  • Participates in evening Credentialing Committee meeting on a monthly basis

  • Record minutes from Credentialing Committee

  • Supports special projects as needed.

  • Other Duties as assigned.

  • Qualifications:

    Bachelor’s degree preferred; HS and applicable experience considerd. 2-3 years experience in behavioral health environment preferred. Previous credentialing experience required. Word, Excel and Powerpoint experience required Strong organizational skills and attention to detail required.

    SupervisionExercised:

    None

    SupervisionReceived:

    Yes

    Classifications:

    Non-Exempt

    Beacon Health Strategies, LLC - 19 months ago - save job - block
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    COMPREHENSIVE CARE SINCE 1996 In close partnership with health plans, we help bring together the fragmented pieces of healthcare to achieve...