Supervisor, Provider Enrollment&Credentialing
About The Position
Description Essential Job Functions Data collection and management Collects provider credentials and updates internal/external databases Streamlines onboarding process/workflow for individual providers, practice locations, and physician groups Interacts with varied levels of management, office staff, and physicians effectively to complete various elements of enrollment/credentialing Maintain confidentiality of personal provider information Keep provider data up to date in databases Ensures requisite licenses, malpractice coverage, and certifications are all current for all providers/groups Submit credentialing applications and supporting documentation in a timely manner to cover all dates of service for providers Maintain provider/group demographic info and rosters including terminations, add-on, etc. Individual revalidations with various insurance payors Coordinate and prepare reports in a timely matter; weekly and monthly Provide aggressive follow up with insurance payors regarding credentialing status Maintain deficiency reports for all credentialing applications, developments, and issues Maintain CAQH accounts for providers, including supporting documentation Address AR billing claim issues related to provider enrollments Supervision of start-up projects and expansions Other RCM initiatives that support the Omega scope of client services Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance. Qualifications 5 years of experience in provider enrollment/credentialing within a multi-location physician practice management company, RCM, or healthcare system.
Requirements
- 5 years of experience in provider enrollment/credentialing within a multi-location physician practice management company, RCM, or healthcare system.
Responsibilities
- Data collection and management
- Collects provider credentials and updates internal/external databases
- Streamlines onboarding process/workflow for individual providers, practice locations, and physician groups
- Interacts with varied levels of management, office staff, and physicians effectively to complete various elements of enrollment/credentialing
- Maintain confidentiality of personal provider information
- Keep provider data up to date in databases
- Ensures requisite licenses, malpractice coverage, and certifications are all current for all providers/groups
- Submit credentialing applications and supporting documentation in a timely manner to cover all dates of service for providers
- Maintain provider/group demographic info and rosters including terminations, add-on, etc.
- Individual revalidations with various insurance payors
- Coordinate and prepare reports in a timely matter; weekly and monthly
- Provide aggressive follow up with insurance payors regarding credentialing status
- Maintain deficiency reports for all credentialing applications, developments, and issues
- Maintain CAQH accounts for providers, including supporting documentation
- Address AR billing claim issues related to provider enrollments
- Supervision of start-up projects and expansions
- Other RCM initiatives that support the Omega scope of client services
- Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
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What This Job Offers
Education Level
No Education Listed
