Credentialing Manager jobs in Nashville, TN
Recently Added Credentialing Manager jobs
Credentialing Manager
- Advanced Billing Consultants
-
Goodlettsville, TN
FULL_TIME
-
It’s your choice, choose Advanced Billing Consultants. Advanced Billing Consultants specializes in medical billing services, accounts receivable, and information management for medical practices. Join our growing team. We promote a fun and friendly work environment. We encourage work/life balance and we offer competitive wages and benefits.The Credentialing Manager oversees credentialing and project management for Multi-specialty practices that join AdvancedHEALTH.Job Duties:
- Provide leadership and supervision to credentialing staff
- Creates and edits policies, procedures, methods, and guidelines
- Set goals and expectations for credentialing staff
- Utilizes metrics to improve performance
- Ensures that assignments are completed accurately and on time
- Monitors quality and quantity of staff workflow by performing periodic audits/reviews
- Oversees credentialing of new and current providers and locations
- Oversees the maintenance and update of information on providers including State Licenses, DEA, facility privileges, etc.
- Handle W-9 requests
- Oversees Update of provider information in Symed Database
- Assist billing department with credentialing issues
- Oversees Reporting of current credentialing status with weekly payer grids
- Oversees Initial completion of CAQH application and update as needed for re-credentialing
- Knowledge of all insurance payers to credential providers
- Advise staff of uncertain credentialing information received and any issues identified during the process in a timely fashion
- Prompt processing of all requests to credential
- Handles Pain Management Facilities
- Oversees diligent form completion for clean application when submitted
- Handles initial onboarding of all multi-specialty practices
- Perform other tasks as requested by COO
Position Requirements:- High School or Equivalent
- Minimum of 2-5 years’ experience in medical billing preferred
- Minimum of 1-3 years’ experience in medical Credentialing supervision preferred
- Knowledge of Symed (Credentialing Database) preferred
- Knowledge of Payer requirements for submitting applications
- Thorough knowledge of CAQH
Skills and Abilities:- Expectational customer service and the ability to communicate with patients, physicians, clients, coworkers and management staff
- Demonstrate commitment to quality by credentialing in compliance with all applicable regulations and requirements
- Must demonstrate strong analytical skills and proficiency with Microsoft office products
- Must have strong critical thinking skills
- Maintains effectiveness when experiencing major changes in work tasks or the work environment
- Ability to work independently without close supervision
- Ability to exercise judgement and make decisions
- Ability to perform in a high productivity, fast-paced environment
- Interpersonal skills and conflict resolution
- Attention to detail
- Excellent phone and computer skills
- Ability to maintain sensitive information in confidence
- Ability to train staff and write protocols and training materials
- Ability to meet deadlines and prioritize responsibilities
- Strong ability to uphold organizational values, work with integrity and ethically, inspire the trust of others, and treat people with respect
- Strong HIPAA and OSHA knowledge
- 14 Days Ago
Credentialing Verifier
- Parallon
-
Nashville, TN
FULL_TIME
- Schedule: Full-time (40hrs per week) Introduction Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Credentialing Verifier with Parallon you can...
- 15 Days Ago
Credentialing Coordinator
- Parthenon Management Group
-
Brentwood, TN
FULL_TIME
- Parthenon Management Group POSITION DESCRIPTION Position: Credentialing Coordinator Reports to: Director of Certification - We are Solutionaries. Parthenon Management Group is an association managemen...
- 15 Days Ago
Credentialing Coordinator
- 8106B Parthenon Management Group, LLC
-
Brentwood, TN
FULL_TIME
- Parthenon Management Group POSITION DESCRIPTION Position: Credentialing Coordinator Reports to: Director of Certification ------------------------------------------------------------------------------...
- 16 Days Ago
Credentialing Specialist
- Parallon
-
Nashville, TN
FULL_TIME
- Schedule: Full-time Days (Work from Home/Virtual) Introduction Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Credentialing Specialist ope...
- 1 Month Ago
Credentialing Verifier II
- Parallon
-
Nashville, TN
FULL_TIME
- Introduction Do you have the career opportunities as a Credentialing Verifier II you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nati...
- 2 Months Ago
Filters
- Current Active Filter
- Nashville, TN
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Credentialing Manager jobs found in Nashville, TN area
Enterprise Account Executive-SaaS
- Kimedics
-
Nashville, TN
- Do you love building relationships and solving problems for potential customers? Are you an independent self-starter loo...
- 4/25/2024 12:00:00 AM
LN Concerts, Project Manager - Festivals
- Live Nation Entertainment, Inc.
-
Nashville, TN
- Job Summary: WHO ARE WE? Live Nation Entertainment is the world's leading live entertainment company, comprised of globa...
- 4/25/2024 12:00:00 AM
Systems Security Analyst / Cybersecurity Engineer / Mostly Remote
- Global Engineering & Technology, Inc.
-
Nashville, TN
- This position requires a current DOE Q or DoD Top Secret security clearance. THIS IS A HYBRID-REMOTE POSITION. In its ma...
- 4/24/2024 12:00:00 AM
Systems Security Analyst / Cybersecurity Engineer / Mostly Remote
- Global Engineering & Technology, Inc.
-
Nashville, TN
- This position requires a current DOE Q or DoD Top Secret security clearance. THIS IS A HYBRID-REMOTE POSITION. In its ma...
- 4/24/2024 12:00:00 AM
Tennessee Office Leader I
- Hntb Corporation
-
Nashville, TN
- Position or Keyword (Leave blank to see all)nefits information: HNTB Total RewardsClick here to learn more about EOE inc...
- 4/24/2024 12:00:00 AM
Case Manager
- Opex Solutions Inc
-
Smyrna, TN
- Job Description Job Description Benefits: Bonus based on performance Tuition assistance Education: RN, or LPN required E...
- 4/23/2024 12:00:00 AM
Systems Security Analyst / Cybersecurity Engineer / Mostly Remote
- Global Engineering & Technology Inc.
-
Nashville, TN
- This position requires a current DOE Q or DoD Top Secret security clearance. THIS IS A HYBRID-REMOTE POSITION. In its ma...
- 4/22/2024 12:00:00 AM
Case Manager
- Opex Solutions Inc
-
Smyrna, TN
- Job Description Job Description Education: RN, or LPN required Experience: Proficient with MS office suite & Adobe produ...
- 4/22/2024 12:00:00 AM
About Nashville, Tennessee
Nashville is the capital and most populous city of the U.S. state of Tennessee. The city is the county seat of Davidson County and is located on the Cumberland River. The city's population ranks 24th in the U.S. According to 2017 estimates from the U.S. Census Bureau, the total consolidated city-county population stood at 691,243. The "balance" population, which excludes semi-independent municipalities within Davidson County, was 667,560 in 2017.
Located in northern Middle Tennessee, Nashville is the main core of the largest metropolitan area in Tennessee. The 2017 population of the entire 14-...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Credentialing Manager jobs
$45,934 to $91,933
Nashville, Tennessee area prices
were up 1.3% from a year ago
were up 1.3% from a year ago
What does a Credentialing Manager do?
Credentialing Manager
Develops strong knowledge of the credentialing software, and full capabilities, to maximize its use and understands the functionality of the claims software, as it relates to the credentialing process.
September 07, 2022
Manage operations for the credentialing and recredentialing process to satisfactorily meet all standards as required by HMSA policies and procedures, state and federal regulatory requirements and all relevant accreditation standards pertaining to the credentialing for HMSA providers in all lines of business including commercial, Medicare, Medicaid and ACA products.
October 31, 2022
Prepares,reviews and submits credentialing applications as determined by state, federalor accrediting agency guidelines and standards for review, recommendations anddecision by the appropriate organizational committee or body.
November 22, 2022
Monitor Medicaid and Medicare sanctioning reports to ensure compliance with Health Care Financing Administration (HCFA) requirements regarding prohibition of excluded provider participation.
January 15, 2023
Maintains a thorough understanding of medical staff bylaws, Joint Commission standards, hospital organization and policies, medical staff rules and regulations, national practitioner data bank regulations and procedures, credentialing and privilege delineation procedures and medico-legal issues.
February 02, 2023
Assists in the development and implementation of medical record practices policies and procedures to ensure the timely, quality, and accurate delivery of medical record services.
March 23, 2023
Provides day to day supervision of site-specific medical record services and staff consistent with established policy and regulatory requirements, and statutes governing health information management practices.
April 03, 2023
Review and update departmental policies and procedures to ensure compliance with NCQA, CMS and other regulatory agencies.
April 26, 2023
Manages the processes of region-wide, complex information systems needs in project areas such as new business operating models, innovative approaches to IT solutions support, market research of emerging or available product functionality and operational readiness assessment.
May 10, 2023
Plans and directs program for orientation of new medical staff members to the hospital environment and duties and responsibilities of medical staff membership.
May 19, 2023