Manager of Credentialing

Our Revenue Cycle Management Team is hiring a Manager of Credentialing!

The Position is remote, but the team is looking for someone in either Central or Eastern Time Zones

Office Hours: 8am-5pm, no nights, no weekends.

• This role is ideal for a person with Credentialing, Provider Enrollment experience and Managerial experience
  
  
  

Credentialing Manager administers the physician and mid-level payor enrollment and hospital privilege credentialing applications process. The Credentialing Manager is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual providers and clients with payors and hospitals. In this role, you will ensure the setup of the clients for participation status in the EMR, prepare and submit applications, follow up on the status of applications and track the progress on all pending applications.

Responsibilities Include

Perform all duties for credentialing lead and credentialing coordinator in addition to the following:

• Oversees department’s work queues and productivity reports to ensure timely submission of credentialing documents.
• Develops and implements standardized guidelines.
• Provide leadership, training, and review credentialing to evaluate performance of credentialing leads and coordinators.
• Manage, identify, research, resolve, and report any issues involving daily workflow and quality of work.
• Works with revenue cycle management to ensure compliance guidelines are established consistently throughout organization.
• Participates in and/or supports the Orientation of newly hired staff members.
• Maintains both internal and external customer and client relationships as required and manages expectations related to the performance of deliverables and non-standard issue resolution.
• Maintain compliance with Federal and State regulations.
• Budget Management for department.
• Process improvement for department.
• Perform other duties and responsibilities as required, assigned, or requested.
  
  
  

Qualifications

• High School Diploma or GED required. Bachelor’s degree preferred.
• Minimum of 2 years credentialing experience.
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook.
• Knowledge of the Medicare, Medicaid & third-party provider enrollment processes.
• Hospital privilege experience including but not limited too primary sourcing.
• Proficiency in CAQH, PECOS & NPPES
• Microsoft SharePoint experience.
• Knowledge of NCQA & JACHO guidelines. Knowledge of credentialing software.
  
  
  

The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment

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