Behavioral Health - Financial Counselor & Credentialing Specialist

Description

The Renfrew Center of Philadelphia (Roxborough area) offers an unmatched opportunity, in the field of eating disorders, for a Behavioral Health – Financial Counselor & Credentialing/Contracting Specialist to work in an environment that changes lives. The Renfrew Center provides opportunities for individuals of all backgrounds, that have the desire and passion to foster a positive outcome and impact on our patients’ lives.

The Renfrew Center’s research-based treatment model, for eating disorders, is focused on treating the whole person and helping them lead a rich and fulfilling life. As a patient and family facing role, candidate should bring:

· Strong customer service skills and ability to communicate empathetically and professionally.

· Excellent attention to details, organization, time management, and follow-through.

· Strong verbal and written communication skills with patients, providers, payors, and internal teams.

· Ability to Manage multiple priorities, deadlines, and follow-up tasks in a fast-paced environment.

· Problem solving skills and ability to escalate barriers appropriately. 

Our commitment to you – We are committed to providing every employee the opportunity for personal and professional development through:

• 401(k) with company match
• Healthcare benefits
• Vacation and sick days
• Employee referral program
• Employee discounts to various stores, amusement parks,      events, etc.
• Continuing education (CE) programs and training
• Advancement opportunities within the organization

Position Responsibilities: 

• Verify patient insurance eligibility, benefits, coverage limitations, authorizations, deductibles, co-pays, coinsurance, and out-of-pocket responsibilities for behavioral health services.
• Communicate clearly and compassionately with patients regarding estimated costs, payment expectations, financial assistance options, and available payment arrangements.
• Assist patients with financial applications, self-pay arrangements, and required documentation.
• Coordinate with admissions, authorization team, clinical, and administrative teams to support timely access to care and facilitate communication.
• Manage provider credentialing and re-credentialing processes with commercial, Medicaid, Government Programs, managed care, EAPs, and behavioral health payors as applicable.
• Collect, verify, and maintain provider documentation, including licenses, certifications, malpractice insurance, CAQH profiles, NPI information, board certifications, and required payor forms to complete credentialing and recredentialing as well as new contracts.
• Track credentialing deadlines, enrollment status, revalidation dates, license expirations, payor approvals, and follow-up requirements to prevent enrollment gaps.
• Prepare and submit payor enrollment applications, demographic updates, roster updates, contract requests (including Single Case Agreements), and re-credentialing packets accurately and on time.
• Serve as a liaison between Renfrew, payors, billing partners, and internal leadership to resolve credentialing, enrollment, claims setup, or reimbursement-related issues.
• Monitor payor requirements and communicate updates that may affect provider participation, billing readiness, or patient financial clearance.
• Prepare reports on credentialing status, outstanding enrollment items, and upcoming projects.

Requirements

Education, Competencies and Credentials:  

• High school diploma or equivalent required; undergraduate degree preferred.
• Minimum of 2 years of experience in healthcare revenue cycle, patient financial counseling, credentialing, payor enrollment, medical billing, behavioral health administration, or a related healthcare setting preferred and to include:
• Knowledge of insurance eligibility, benefits verification, patient responsibility, claims workflow, and payor requirements.
• Familiarity with provider credentialing, NPI, payor enrollment, re-credentialing, and provider data maintenance.
• Experience working with behavioral health payors, Medicaid, managed care organizations, and Single Case Agreements.
• Strong proficiency with Microsoft Office applications and ability to learn electronic health record platforms, billing, and credentialing systems.

Hours: 40 hours per week Monday - Friday

The Renfrew Center provides cisgender adolescent girls and adult women, transgender, and non-binary individuals with the tools they need to succeed — in recovery and in life. Offering a warm, nurturing environment, Renfrew’s treatment philosophy emphasizes the importance of a collaborative therapeutic relationship, a feminist-relational approach, and the belief that every person needs to actively participate in their own recovery