Credentialing Manager

Credentialing Supervisor

The Credentialing Supervisor will report to the credentialing supervisor and/or office supervisor.

Job Overview: This position entails communicating directly with the providers in person, via email and/or via phone, as well as hospitals and/or insurance companies. You will be responsible for enrolling and maintaining the participation status of the providers with hospitals and/or insurance companies, as well as verifying demographic information and providing up to date licensures to ensure the most accurate information is on file for the providers.

Responsibilities and Duties:

· Communicate with provider to obtain all documents necessary to credential.

· Contact insurances and/or hospitals to initiate the application process.

· Complete and submit hospital and/or insurance applications with all necessary signatures and applicable documents.

· Communicate with the insurances and/or hospitals to follow up on the status of applications.

· Complete and submit Electronic Remittance Advice and Electronic Funds Transfer forms.

· Transfer letters in notes, scan, and file

· Input detailed notes of daily activity in spreadsheet.

· Verify, complete & submit provider demographic forms to insurances.

· Send out updated licensures upon renewal to insurances and/or hospitals.

· Maintain email volume, work in a timely manner.

· Answer phone, attend call and/or route as needed.

· Review and approve insurance contracts.

· Manage fee Schedule Negotiations.

· Manage CAQH updates and attestation.

· Track and ensure all credentialing for all employees on site and remote.

· Manage Credentialing Software.

· Assist employees with questions or concerns.

· Enforce office rules and regulations.

· Provider disciplinary action when required.

· Set new credentialing guidelines.

· Assist employees with daily work duties.

· Resolve any issue at hand by using resources available.

Qualifications:

• High School Diploma
• 5 years credentialing experience

Skills:

· Microsoft word, Excel, Outlook

• Basic computer skills
• Multi-task
• Detail-oriented
• Able to work fast pace
• Self-motivated
• Positive attitude
• Professional personality
• Organization
• Follow-up skills
• Able to handle high volume workload
• Customer Service
• Good Communication

Job Type: Full-time

Schedule:

• Monday to Friday

Ability to Relocate:

• Webster, TX 77598: Relocate before starting work (Required)

Work Location: In person