Supervisor, Provider Enrollment&Credentialing

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.