Peak Vista Community Health Centers is a non-profit healthcare organization whose mission is to provide exceptional healthcare to people facing access barriers.  We provide primary care services (medical, dental and behavioral healthcare) through 28 outpatient health centers in El Paso, Teller, Lincoln, Adams, Elbert, and Kit Carson counties.  We deliver care with our strong “Hospitality” culture.  Our organization has over 800 employees and serves 82,000 patients in the Pikes Peak & East Central Plains region.  Peak Vista is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).

Job Summary (Essential Functions)
Summary:  The Payer Credentialing and Contract Specialists support provider and payer credentialing functions.
 
Essential Duties and Responsibilities include the following.  Other duties may be assigned. 
 

• Performs all processes necessary for provider credentialing and re-credentialing with payers.
• Maintain record of credentialing application status and provide updates regularly to Revenue Cycle Leadership.
• Tracks organizational agreements with payers, maintaining an electronic inventory of provider credentialing and reimbursement details.
• Evaluates, audits and maintains existing agreements to include all aspects of file management (ensuring timely renewal and managing data requests to ensure payer compliance).
• Stays current on contract changes and update staff and other departments in Peak Vista of changes.
• Works with organizational leadership to support agreement implementation.
• Works with external parties in the resolution of payer issues due to credentialing and other contract problems.
• Recommends changes to payer agreements and provider credentialing processes, based on trends in Peak Vista data.
• Carries out all duties and responsibilities in an exemplary manner in accordance with established standards of professionalism, ethics, and customer service.
   

Qualifications

Education/Experience:
 
Education: Associate's Degree in a business or health care related field preferred. Equivalent experience acceptable in lieu of education.
 
Work Experience: 1year experience in health related field required
 
Language Ability:
Must have superior communication and customer service skills
 
Math Ability:
Payment balancing experience desired. ICD-10 and CPT-4 coding desired.
 
Reasoning Ability:
Ability to handle multiple tasks simultaneously in a timely manner, ability to communicate
in person, by phone and in writing in a clear, concise and professional manner, ability to reason and prioritize responsibilities effectively and ability to resolve problems with minimal assistance.
 
Computer Skills:
Data entry skills required, expedient and accurate use of 10 key and basic computer
skills required.
 
Certificates and Licenses: 
 

Physical Demands

The employee must occasionally lift and/or move up to 50 pounds. While performing the duties of this Job, the employee is regularly required to sit. The employee is occasionally required to stand and walk.


*Successful candidates will complete pre-employment screening; which includes, but is not limited to a Criminal Background check. Peak Vista Community Health Centers is a drug and alcohol free workplace an an Equal Opportunity Employer.