What are the responsibilities and job description for the Credentialing Team Lead position at OrthoCarolina?
Lead day-to-day operations and support for the credentialing and provider support team, acting as primary lead in the manager's absence.
Supervise onboarding and credentialing workflows for 100 providers including MDs, PAs, NPs, PTs, and OTs across multiple facilities and specialties.
Train and mentor new staff, ensuring adherence to SOPs and continuous improvement of onboarding and enrollment processes.
Develop and maintain tracking systems and databases for licensure, DEA, malpractice insurance, board certification, CME, and hospital privileges. Serve as liaison between Human Resources, Compliance, Billing, and external payers to ensure credentialing requirements are completed accurately and on time.
Oversee termination tracking and updates to managed care databases (Infolink).
Drive process improvement initiatives that improved credentialing turnaround times and enhanced communication with internal departments.
Schedule orientation and interviews for new providers to support seamless onboarding experience.
Maintain confidentiality and compliance with regulatory and accreditation standards.
At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization. OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement. To learn more about Team OC please visit https://www.orthocarolina.com/about-us
OrthoCarolina is seeking a qualified professional to join our team as a Provider Support Service Coordinator.
The Provider Support Services Coordinator ensures all applications for initial appointment, reappointments and privileges of medical providers (physicians, physician assistants, therapists, organization, clinics, DME, etc.) for appropriate hospitals, managed care organizations and malpractice insurance coverage are completed and processed in a timely manner. This position also maintains licensure (including medical license, DEA and privilege license) for physicians, physician assistants and clinics and current documentation on medical providers for hospitals and participating managed care organizations.
Essential Functions
Regular
Qualifications
Skills
Communication, Customer Service, Data Entry, Health Insurance, Patient Care Documentation, Scheduling, Teamwork, Time Management
Education
Certifications
Language
Supervise onboarding and credentialing workflows for 100 providers including MDs, PAs, NPs, PTs, and OTs across multiple facilities and specialties.
Train and mentor new staff, ensuring adherence to SOPs and continuous improvement of onboarding and enrollment processes.
Develop and maintain tracking systems and databases for licensure, DEA, malpractice insurance, board certification, CME, and hospital privileges. Serve as liaison between Human Resources, Compliance, Billing, and external payers to ensure credentialing requirements are completed accurately and on time.
Oversee termination tracking and updates to managed care databases (Infolink).
Drive process improvement initiatives that improved credentialing turnaround times and enhanced communication with internal departments.
Schedule orientation and interviews for new providers to support seamless onboarding experience.
Maintain confidentiality and compliance with regulatory and accreditation standards.
At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization. OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement. To learn more about Team OC please visit https://www.orthocarolina.com/about-us
OrthoCarolina is seeking a qualified professional to join our team as a Provider Support Service Coordinator.
The Provider Support Services Coordinator ensures all applications for initial appointment, reappointments and privileges of medical providers (physicians, physician assistants, therapists, organization, clinics, DME, etc.) for appropriate hospitals, managed care organizations and malpractice insurance coverage are completed and processed in a timely manner. This position also maintains licensure (including medical license, DEA and privilege license) for physicians, physician assistants and clinics and current documentation on medical providers for hospitals and participating managed care organizations.
Essential Functions
- Coordinates credentialing/re-credentialing process by maintaining communication and assistance with other OrthoCarolina employees, hospital medical staff departments, representatives from managed care organizations and malpractice underwriter by gathering appropriate credentialing and re-credentialing information such as signatures and documents.
- Maintains current credentialing files of medical providers to include state licensure, DEA, certificate of insurance, board certification and CME’s.
- Notifies Business Office representative of participation, terminations and changes for managed care database maintained. Maintains a current confidential database of physicians and physician assistants state licensure and DEA’s located on S: drive for clinical and triage staff use only.
- Renews state license and DEA for physicians, fellows and physician assistants. Maintains an Excel spreadsheet for tracking renewal dates.
- Assists new physicians and physician assistants in scheduling hospital orientations and interviews necessary to obtain hospital privileges.
- Renews North Carolina Department of Revenue Privilege License for all physician’s and fellows, annually.
- Responsible for written notification to hospitals, managed care organizations and malpractice carrier of all provider, clinic, and organization changes/terminations.
Regular
Qualifications
Skills
Communication, Customer Service, Data Entry, Health Insurance, Patient Care Documentation, Scheduling, Teamwork, Time Management
Education
Certifications
Language