ADMINISTRATIVE PROGRAM SPECIALIST B-FISCAL/BILLING

Administrative Program Specialist BWe believe that our individual differences are our strength, and it forms the foundation that allows our agency to empower individuals to experience a greater quality of life. Our agency's vision is that all people will be empowered to lead meaningful and productive lives among friends, relatives, and neighbors regardless of behavioral health needs or developmental disabilities. We have been lighting the path forward into recovery by providing person-centered services to adults and children who meet the treatment criteria for substance use disorders, developmental disabilities, and/or mental health.Come join our team at Florida Parishes Human Services Authority as an Administrative Program Specialist B and help keep our provider and clinic credentialing and enrollment processes running smoothly. If you are organized, detail-oriented, and enjoy working with providers, insurance companies, and internal staff, this is a great opportunity to support accurate billing, timely payments, and quality services for the individuals we serve!

An ideal candidate shall possess the following competencies:Driving Results: The ability to set and pursue goals, maintain focus amid competing demands, and deliver results.Following Policies and Procedures: The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.Minimum Qualifications:Four years of experience in administrative services; ORSix years of full-time work experience in any field plus one year of experience in administrative services; ORA bachelor's degree plus one year of experience in administrative services; ORAn advanced degree.Experience substitution: Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.Job Specification:The official job specifications for this role, as defined by the State Civil Service, can be found here.Job Duties and Other Information:Job Duties: This position serves as a Credentialing Specialist for the agency and is responsible for the initial and ongoing credentialing, recredentialing, and enrollment of licensed clinical and medical staff with governmental and commercial insurance payers. The incumbent must work independently and demonstrate a high level of both interpersonal and communication skills (verbal and written). Duties of this position include:Managing provider and clinic credentialing, recredentialing, and enrollment with Medicaid, Medicare, managed care organizations, commercial insurance carriers, and other third-party payers, ensuring timely applications, revalidations, and continued participation.Maintaining accurate provider and clinic enrollment and credentialing records, including provider rosters, specialty and taxonomy assignments, practice locations, payer participation, and required documentation.Coordinating provider additions, changes, terminations, and payer roster updates, while monitoring credentialing requirements and resolving issues that could affect billing, service authorizations, claims payment, or agency revenue.Researching and resolving credentialing-related claim denials, reimbursement issues, and enrollment discrepancies in coordination with billing staff, the Utilization Coordinator, insurance carriers, and other payer representatives.Serving as the primary liaison with insurance companies and payers regarding provider contracting, enrollment, credentialing, participation, authorization-related matters, and changes to payer requirements.Monitoring payer policies, bulletins, newsletters, provider manuals, contracts, and participation agreements and communicating updates and potential operational impacts to leadership and relevant departments.Maintaining CAQH profiles and credentialing compliance, including monitoring professional licenses, certifications, DEA registrations, malpractice insurance, and other requirements and ensuring current documentation is submitted to CAQH and payer portals.Maintaining organized, secure, and confidential credentialing and billing documentation in accordance with agency policies, payer requirements, HIPAA, record-retention schedules, and applicable regulations, including preparing records for audits, reviews, medical record requests, and compliance activities.Position-Specific Details:Appointment Type: ProbationalCareer Progression: This position will be filled as an Administrative Program Specialist BCompensation: The salary range for the position is below.Location: Executive Administration/Billing Department is housed in Hammond, Louisiana.Benefits:Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service.

With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:Insurance CoverageParental Leave – Up to six weeks paid parental leaveHolidays and Leave – State employees receive the following paid holidays each year:New Year's DayMartin Luther King, Jr. Day,Mardi Gras,Good Friday,Memorial Day,Independence Day,Labor Day,Veteran's Day,Thanksgiving Day and Christmas Day.Additional holidays may be proclaimed by the Governor State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works).

These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):Louisiana State Employees Retirement System ( Retirement System of Louisiana ( School Employees Retirement System ( among others