Credentialing Supervisor

The Provider Enrollment Supervisor is responsible for assisting with the day-to-day activities of the Provider Enrollment Department, act as the first line leader to staff, and contributes to the development of processes and procedures.

Essential Job Functions:

• Supervise and support credentialing staff responsible for licensing, credentialing, privileging, enrollment, reappointments and/or maintenance of professional credentials.
• Work with Provider Enrollment Manager to complete employee relation duties as necessary such as coaching, mentoring, corrective action, or similar.
• Review, edit, and process employee timecards, and schedules.
• Assist with or prepare annual performance reviews for credentialing staff.
• Send Medicare Revalidation reminders for all providers.
• Monitor held claims in AIMs/Work release emails for held claims.
• Conduct client calls to provide status updates on clients.
• Work with AR to research credentialing related denials.
• Work with Data Processing to research credentialing related rejections.
• Ensure any questions regarding releases are answered in a timely fashion.
• Responsible for ensuring Medicare credentialing items are completed timely.
• Work with Client Management to provide support on client concerns and updates.
• Credential for special projects and provide additional support as needed.
• Meet staff for one-on-one touch base on performance/feedback concerns.
• Work with Payments for requested EFT enrollments/updates.
• Other duties as assigned.

Required Skills:

• Excellent verbal and written communication skills.-will be a constant thing to work on
• Proficient in Microsoft Office Suite and proprietary database applications.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to multi-task, manage priorities and meet critical deadlines.-will be a constant thing to work on
• Ability to work independently and in a fast-paced environment.
• High level of awareness of pertinent details; excellent organizational skills.

Education and Experience:

• High school diploma or equivalent required, college degree preferred.
• Knowledge of NCQA standards as it relates to credentialing and health plan enrollment.
• Knowledge of medical terminology as it relates to specific privileges.

Salary: $65,000

Schedule: M-F 8am-4:30pm EST HYBRID (flexible)

Additional Benefits:

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