What are the responsibilities and job description for the Credentialing Manager/Office Manager position at Albemarle Therapy Center?
Job Overview
We are seeking a dynamic and detail-oriented Credentialing Manager to lead our credentialing operations and ensure compliance with industry standards within a pediatric Rehabilitation Clinic providing Speech Therapy, Occupational Therapy, and Physical Therapy in Waynesboro Location. In this vital role, you will oversee the credentialing process for healthcare providers, manage relationships with insurance payers and licensing boards, and uphold the highest standards of accuracy and efficiency. Your expertise will help facilitate seamless provider onboarding, maintain regulatory compliance, and support our mission to deliver exceptional healthcare services. If you thrive in a fast-paced environment, possess strong organizational skills, and are passionate about maintaining the integrity of credentialing processes, this is an exciting opportunity to make a meaningful impact.
Duties
- Officer Manager managing the day to day in the clinic and office supplies
- Lead the end-to-end credentialing process for Therapist providers, including initial applications, re-credentialing, and ongoing updates
- Collaborate with medical offices, providers, insurance companies, and licensing agencies to gather necessary documentation and verify credentials
- Ensure all credentialing activities comply with industry standards such as NCQA (National Committee for Quality Assurance) requirements and managed care regulations
- Take referrals and maintain a waitlist
- Maintain accurate and up-to-date records of provider credentials, licensure, certifications, and other pertinent documentation
- Monitor payer credentialing deadlines and facilitate timely submissions to prevent coverage disruptions
- Review medical terminology related to provider qualifications to ensure proper classification and documentation
- Develop and implement streamlined workflows to improve efficiency in credentialing operations
- Stay informed about changes in managed care policies, NCQA standards, and healthcare regulations that impact credentialing procedures
Qualifications
- Proven experience in healthcare credentialing or provider enrollment management
- Strong understanding of managed care processes and payer requirements
- Prior medical office experience is highly desirable for understanding clinical workflows and provider needs
- Excellent knowledge of medical terminology to accurately interpret credentials and documentation
- Familiarity with NCQA standards and other accreditation requirements governing healthcare organizations
- Exceptional organizational skills with the ability to manage multiple deadlines simultaneously
- Strong communication skills for effective collaboration with providers, payers, and regulatory bodies
- Detail-oriented mindset with a focus on accuracy and compliance
Join us in ensuring our healthcare providers are credentialed efficiently and accurately! This role offers an opportunity to contribute significantly to our organization’s success while supporting high-quality patient care through meticulous credentialing practices.
Job Type: Full-time
Pay: $46,416.98 - $55,900.02 per year
Benefits:
- Health insurance
- Paid time off
Work Location: In person
Salary : $46,417 - $55,900