Senior Credentialing Analyst

Duet

91d

About The Position

Duet empowers Nurse Practitioners (NP) to tackle the primary care crisis by leading their own practices, closing the gap in access while keeping care local. We're a well-funded seed-stage company led by experienced entrepreneurs and Nurse Practitioners, and backed by investors like Lerer Hippeau and Kairos. We’re building a vertically integrated platform for NP practices to thrive as standalone businesses in a time of corporate consolidation. Think of workflows to engage patients, streamline administration, forecast business growth, and drive high-quality care and value-based outcomes while building community among NPs. These solutions sit on a foundation of data that we harness across patients and providers for the benefit of care and business success.

Requirements

• 3+ years experience in provider credentialing and privileging processes
• Early-stage startup background preferred
• Primary care setting experience and familiarity with EHRs, billing/coding systems, and value-based care preferred
• Demonstrated knowledge of credentialing principles, industry regulations, state and federal law, and accreditation standards
• Strong project management and organization skills
• Experience with credentialing platforms and related software
• Bachelor's Degree, preferable in a related area of study

Responsibilities

• Executes the end-to-end credentialing process for our network of nurse practitioners
• Develops, implements, and continuously improves credentialing, re-credentialing, and privileging processes, policies, and procedures to ensure compliance with regulatory requirements.
• Audits and assesses the effectiveness and efficiency of both delegated and non-delegated credentialing end-to-end processes.
• Conducts thorough investigations and verifications of healthcare providers' credentials by directly contacting primary sources.
• Collaborates on, coordinates and supports credentialing committee activities, including scheduling, preparation, facilitation, and documentation of meetings.
• Ensures compliance with and stays abreast of changes to legal and regulatory standards, including NCQA and National Practitioner Data Bank guidelines.
• Leverages technology platforms and software systems to streamline credentialing processes, maintain records, and enhance efficiency.
• Facilitates and participates in payor meetings.
• Collaborate with RCM on credentialing and enrollment related claims projects and denials.

What This Job Offers

• Education Level: Bachelor's degree