Supervisor, Provider Enrollment&Credentialing
About The Position
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.
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
Career Level
Manager
Education Level
No Education Listed
