CENIKOR’S VALUE PROPOSITION - WHAT’S IN IT FOR YOU?

• PURPOSE in your work - service to others, giving back to your community, helping to save lives, being fulfilled at work. See how we served last year.
• COMPETITIVE PAY, BENEFITS, PAID TIME OFF, TUITION REIMBURSEMENT, up to 10% 401K and BONUSES - we hire and reward high performers.
• 1.Benefits for full-time team members include Medical, Dental, Vision, Basic Life & AD&D, LTD, STD, Accident, Critical Illness, HRA/FSA
• STABILITY and GROWTH - more than 55 years in business - our strong financial processes support our drive to serve more people and ensure stability for our team members.
• CONTINUOUS LEARNING and PROFESSIONAL DEVELOPMENT - we are committed to developing our leaders in their desired career path and promoting from within. We have Cenikor Career Pathways Program that you can join after 90 days of employment. We also have an annual leadership development program with assigned mentors to help you achieve your professional goals. More than 25% of our total employees have been promoted the last 4 years.
• STUDENT LOAN FORGIVENESS - The Public Service Loan Forgiveness (PSLF) forgives your qualified student loans if working for a non-profit for a specific period of time. Find out more here.
• The work we do isn’t easy. If you like purposeful hard work, serving others and having FUN with your team while achieving goals, Cenikor will be the right place for you!
  Schedule: Monday- Friday 8am-5pm

QUALIFICATIONS FOR THE POSITION:

? Skills, Knowledge and Abilities:
? Skilled in insurance billing coding and processing.
? Skilled in administrative and clerical procedures.
? Skilled in Microsoft Office and ten-key.
? Ability to possess excellent organization and communication skills.
? Ability to be detail oriented and accurately record numerical data.
? Ability to possess a “can-do” attitude.
? Ability to work in a team environment.
? Knowledge of Microsoft Office software required, including specific MS Outlook
calendar experience.
? Ability to consistently uphold the Core Principles of Cenikor’s Culture:
o Demonstrate mission of service to our clients
o Positive, respectful communication with both staff and clients
o Demonstrate self-motivation and perseverance to achieve goals
o Role model appropriate, professional behaviors including appropriate client
boundaries
o Work effectively as part of a team, helping to set up others for success
Education:
? High School Diploma or GED
? Associate Degree or higher is preferred
Experience:
? 1-3 years of experience with Medicaid & Medicare
? 2-3 years of experience reviewing contracts and handling credentialing process
coming from a healthcare background.
Physical Requirements:
? Sitting in normal position for extended periods of time.
? Reaching by extending hand(s) or arm(s) in any direction.
? Finger dexterity required to manipulate objects with fingers rather than with whole
hand(s) or arm(s), for example, using a keyboard.
? Communication skills using the spoken word.
? Ability to see within normal parameters.
? Ability to hear within normal range.
? Ability to lift file boxes weighing approximately 20 pounds on top of filing cabinets.
? Ability to travel to facilities by various transportation means approximately 25-30% of
the time.
Licensure:
? Valid driver’s license required.

1. Responsible for knowing and following contracted plans’ guidelines, pre-certification requirements and procedures for filing and appealing claims of third-party payers, including Medicaid, Medicare, and commercial insurance.
2. Track, organize and process documentation and activities related to the organization’s contractual arrangements with third party payers.
3. Maintain and update credentialing, applications, documentation, licenses, etc., and performing meticulous accurate, high-quality audits and review of those items, systems, and contracts.
4. Communicate with the Payer Relations Manager to optimize communication with third party payers and facilities related to managed care credentialing applications, status, missing information, contracting, re-credentialing, and payer maintenance.
5. Maintain NPI registry with updated demographics for facilities and all clinicians within the foundation.
6. Monitor and ensure compliance with third party payer contractual obligations and timely credentialing and contract renewals. This includes effective communication with internal departments and staff to prevent lapse of current contracts and completing credentialing and onboarding of new third-party payer contracts to include, but not limited to, commercial insurance, Medicaid, and other third-party payers.
7. Review and analyze contract requirements to ensure completeness and note any compliance requirements.
8. Provide support related to arrangements and schedules for audits.
9. Responsible for EHR fee schedule maintenance process including on-going updates and revisions, incorporation of code set corrections, revenue code to CPT/HCPCS code mismatch corrections and incorporating updates annually based on newly identified coding updates.
10. Maintain executed payer contracts and files, database with agreements summaries, completes documentations for payer agreements, onboarding, and maintains in contract share drive, & database.
11. Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members.
12. Perform additional duties as assigned and consistent with the functions as defined in this job description.
13. Maintain strict confidentiality on all client and foundation matters and refer questionable issues to supervisor.
14. Ensure completion of Big 5 performance management tool by the required deadlines and use of SMART goals to support annual performance compensation review.
15. Perform additional duties as assigned and consistent with the non-exempt functions as defined in this job description.