Contracts and Credentialing Specialist

Who is Gateway Foundation?

Gateway Foundation, Inc. is a national non-profit dedicated to helping individuals with substance use and mental health disorders. Established in 1968, Gateway provides essential tools and knowledge for recovery, positively impacting hundreds of thousands of lives. Operating through its Community Services, Corrections Divisions, and Corporate Headquarters, the organization is recognized for innovative, effective treatment approaches and maintaining high standards.

Why join us?

Discover a rewarding career where you can find both personal and professional fulfillment while aligning your values with your work. You'll have the opportunity to make a meaningful impact by aiding individuals in overcoming addiction. We pride ourselves on being an organization that values you and strives to be an employer of choice, fostering a vibrant culture that promotes teamwork and professional growth. Your voice matters here; we actively listen to and value our employees' thoughts, allowing you to be part of organizational decisions. At Gateway Foundation, diversity, equity, and inclusion are principles that we embrace in every community we serve. Additionally, enjoy access to wellness programs, including weekly yoga sessions and chair massages. Join Gateway Foundation today and become part of a team dedicated to making a positive difference in the lives of others.

Contracts and Credentialing Specialists are responsible for:

• Interprets and reviews awarded contracts and contract renewals to ensure the content is correct, acceptable to the company, and to ensure the organization is able to comply.
• Researches contractual terms, and prepares information for contract renewals, amendments, licensing and certification applications, physician and facilities credentialing and re-credentialing.
• Verifies, updates, and maintains records for multiple providers (counselors, nurses, physicians) to ensure that credentials are current for providers to bill for their professional services.
• Creates, implements, and monitors the tracking system for provider credentialing; provides assistance with the contracts management system.
• Obtains national provider identifier (NPI) numbers for facilities and maintains NPI tracking system in order to meet requirements of various new contracts.
• Conducts monthly internal audits on credentialing and re-credentialing files for accuracy and compliance with credentialing policies and procedures to confirm all required verifications are complete and have been performed according to required standards and within required timeframes.
• Gathers various information for facility licensing and certification applications and renewals and insurance credentialing and re-credentialing to ensure accuracy, completion and regulatory and company guidelines compliance.
• Other duties as assigned

Job Requirements:

• Bachelor degree in Public Health, Public or Business Administration or a related field, or a combination of education and relevant experience
• Three to five years (3 - 5) of physician and facility credentialing experience, including experience with system provider contract system configuration and contract interpretation

Physical Requirements:

• Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
• Ability to communicate with others in order to gather and exchange information
• Ability to respond to telephone inquiries
• Ability to continually proofread, check and verify contracts, and data from printed form and computer monitor display
• Ability to use a keyboard and display monitor to enter, retrieve, and/or audit information and data
• Ability to travel to off-site locations

Benefits at Gateway Foundation:

Health and Wellness:

• Medical, dental, and vision insurance for employees and dependents
• Employee wellness program promoting health and fitness and offering cash-saving premiums
• Employee assistance programs focused on mental health

Financial wellbeing:

• 403(b) Retirement Plan with 3% employer match
• Short-term and Long-term Disability and Life and AD&D Insurance paid for by Gateway
• Flexible Spending Accounts for medical and dependent care
• Public Service Loan Forgiveness (PSLF)

Flexibility and time off:

• 18 paid time off days per year - accrual rates increase with years of service
• 9 paid company holidays
• Work-life-balance

Personal Development:

• Training & Development Programs
• Tuition Reimbursement - up to $5,250 per calendar year
• eLearning access to online courses that provide CEU's and job-related training
• Clinical Supervision: Formal and informal guidance

Gateway Foundation is an Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets. Please view Equal Employment Opportunity Posters provided by OFCCPhere.