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Kyo

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Credentialing Specialist

Open 26d posting dated 2 weeks ago

Summary

Credentialing Specialist at Kyo manages insurance and certification processes for ABA therapy staff, ensuring compliance with state/federal rules using databases like CAQH and NPPES.

Kyo is a leading provider of Applied Behavior Analysis (ABA) therapy, dedicated to empowering children with autism and their families to achieve meaningful outcomes. Since 2005, we have partnered with thousands of families across 11 states, delivering effective, convenient, and child-centric ABA therapy designed around each child’s unique strengths, needs and goals. At Kyo, our mission is rooted in a commitment to making every moment count for the children and families we support.

Pay Range: $27.88 - $31.25

Candidates must reside in one of the following states: AZ, CA, CO, FL, GA, OR, TX, UT, TN, TX, WA

Primary job responsibilities may include, but are not limited to:

  • Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
  • Ensuring compliance with various state, federal and payer requirements
  • Responsible for pre-application intake, monitoring, application submission and follow up
  • Maintaining an efficient and compliant on-boarding process
  • Inputing/Updating provider credential databases CAQH and NPPES
  • Ongoing monitoring of clinical staff’s credentials to ensure licenses and certifications are current and active
  • Working closely with internal departments to exchange provider information and follow up on inconsistencies
  • Assisting with other miscellaneous duties in the Revenue and Contracting department

Qualifications:

  • Bachelor's Degree required
  • Demonstrated proficiency with productivity software and project management software (Microsoft Office, G Suite, Asana)
  • Database management skills including querying, reporting, and document generation
  • Ability to work independently and as part of a team
  • Ability to work in a fast paced, expanding organization
  • Strong knowledge of the credentialing process and accreditation and regulatory standards. Ability to lead and facilitate processes through influence and collaboration
  • Working knowledge of Medical Terminology
  • Strong organization and verbal communication skills, attention to details required
  • Ability to use independent judgment to manage and impart confidential information
  • Demonstrated problem-solving skills and initiative to analyze and disseminate relevant credentialing data across internal company departments
  • Ability to make priority determinations without direct supervision
  • Preferred: Experience with provider credential databases CAQH, NPPES
  • Preferred Experience with JIRA
  • Preferred: Experience with HIPAA and compliance-sensitive environments
  • Willingness and ability to provide proof of completed COVID-19 vaccination and booster (if eligible), no later than your scheduled start date. If you believe you are entitled to either a medical or religious exemption to our vaccination requirement, please notify your Kyo interviewer immediately so that your situation can be evaluated by Human Resources

Physical Requirements:

  • Must be able to sit and use a computer for extended periods of time
  • Exhibit manual dexterity to regularly use and enter data into a computer/tablet/phone
  • Ability to read and interpret documents in the English language such as employee handbooks, training materials and procedure manuals
  • No or very limited exposure to physical risk
  • No or very limited physical effort required
  • Ability to perform data entry, operate standard office equipment e.g. copiers, fax
  • Willingness and ability to provide proof of completed COVID-19 vaccination and booster (if eligible), no later than your scheduled start date. (If you believe you are entitled to either a medical or religious exemption to our vaccination requirement, please notify your Kyo recruiter immediately so that your request may be reviewed by HR.)

Apply today to meet with our Talent team and learn more!

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What this application asks

greenhouse

First Name, Last Name, Email, Phone, Resume/CV, Cover Letter, Location

  • Preferred First Name optional
  • LinkedIn Profile optional
  • How did you learn about Kyo? If from a current employee, please list their name(s).
  • Select the highest level of education in which you have completed a degree. choose one
  • What state do you reside in? Note: It is a requirement of this position to be located in one of these listed states. choose one
  • How many years of credentialing/provider enrollment experience do you have? choose one
  • Do you have experience working with CAQH and Availity Portals? choose one
  • Have you worked with MD Staff? choose one
  • Do you have experience with onboarding and licensing new providers? choose one
  • Do you have experience working remotely? choose one
  • Are you willing and able to work Monday-Friday during Pacific Time Hours? choose one
  • Are you able to perform the basic and physical requirements of this job, with or without reasonable accommodation (please refer to the job description for a list of basic and physical requirements)? choose one
  • Kyo is dedicated to protecting vulnerable populations, including youth. As a result, we conduct comprehensive background checks and fingerprint screenings for all potential employees. These screenings will reveal your entire criminal record, including convictions that have been expunged, sealed, dismissed, or otherwise modified, regardless of when the offense occurred. Please note: Having a criminal conviction will not automatically disqualify you from employment. Each case is evaluated individually, taking into account the nature of the offense, its relevance to the role, the time elapsed, and the surrounding circumstances. Are you comfortable undergoing a background check as part of the hiring process? choose one
  • Will you now or in the future require visa sponsorship to work or continue working in the United States? choose one
  • Are you authorized to work lawfully in the United States for Kyo? In compliance with U.S. federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire. Note: If hired, a form I-9, employment eligibility verification, must be completed at the start of employment. choose one
  • By selecting yes, I certify that the information contained in this application is correct to the best of my knowledge. I understand that providing false or misleading information is grounds for withdrawing the offer, or for discharge should I be hired. choose one

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