Medical Provider Salary in Wilmington, DE

Medical Provider/Practitioner Credentialing Supervisor - Average Salary $75,330

The Medical Provider/Practitioner Credentialing Supervisor implements department procedures to facilitate organized and up-to-date provider databases. Oversees day-to-day activities of staff that process credentialing and recredentialing applications for health care providers. Being a Medical Provider/Practitioner Credentialing Supervisor ensures that applications are properly verified and accurately uploaded into an online credentialing database system. Administers system for tracking license and certification expirations to ensure renewals are submitted in a timely fashion. In addition, Medical Provider/Practitioner Credentialing Supervisor resolves complex questions regarding credentialing or provider database maintenance and best practices. Prepares reports on applications and credentialing status to identify trends and improve the credentialing process. May require a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a manager. The Medical Provider/Practitioner Credentialing Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. Working as a Medical Provider/Practitioner Credentialing Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision.

Medical Provider/Practitioner Credentialing Director - Average Salary $147,520

The Medical Provider/Practitioner Credentialing Director develops and implements policies and protocols related to physician, nurse and other employee verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Responsible for all aspects of the verification process for medical staff incumbents. Being a Medical Provider/Practitioner Credentialing Director typically reports to top management. Typically requires a bachelor's degree in area of specialty. The Medical Provider/Practitioner Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. Working as a Medical Provider/Practitioner Credentialing Director typically requires 3+ years of managerial experience.

Medical Provider/Practitioner Credentialing Manager - Average Salary $112,710

The Medical Provider/Practitioner Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Manages staff that process credentialing and recredentialing applications for medical providers. Being a Medical Provider/Practitioner Credentialing Manager analyzes and prepares reports on trends in application status. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. In addition, Medical Provider/Practitioner Credentialing Manager typically requires a bachelor's degree. Typically reports to top management. The Medical Provider/Practitioner Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. Working as a Medical Provider/Practitioner Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required.

Provider Claims Process and Controls Analyst - Average Salary $90,000

The Provider Claims Process and Controls Analyst recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Being a Provider Claims Process and Controls Analyst responds to questions from medical staff and communicates details about policy and guidelines. Establishes the proper codes to use for claims processing. In addition, Provider Claims Process and Controls Analyst requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. Being a Provider Claims Process and Controls Analyst gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Working as a Provider Claims Process and Controls Analyst typically requires 2 to 4 years of related experience.

Provider Claims Process and Controls Manager - Average Salary $129,000

The Provider Claims Process and Controls Manager ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Manages and implements corporate policy and process for medical provider and other reimbursements. Being a Provider Claims Process and Controls Manager requires a bachelor's degree of finance, business or healthcare administration. Evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. In addition, Provider Claims Process and Controls Manager typically reports to head of a unit/department. The Provider Claims Process and Controls Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. Working as a Provider Claims Process and Controls Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required.