Healthcare Credentialing & Contracts Lead

BD; Georgia; Presencial; USD 70.000 - 100.000; Jornada completa

Descripción de la vacante

BD is seeking a Contract Administration Supervisor to oversee application, credentialing and health plan filing processes. You will guide payor escalations, review contracts, and maintain records with strict adherence to Medicare and non-Medicare requirements.

The role requires leadership, strong contract interpretation, and collaboration with Legal, Compliance and Finance to ensure timely, compliant execution of provider agreements.

Formación

• Must have high school diploma or GED.
• Experience in healthcare credentialing, provider enrollment, payer contracting or revenue cycle management.
• Supervisory or team lead experience preferred; capable of directing work and coaching staff.
• Experience with health plan filing and state licensing requirements.
• Ability to interpret contract language and technical procedures.

Responsabilidades

• Manage application, credentialing and health plan filing processes with timely, accurate submissions.
• Provide guidance for payor escalations and interactions regarding contract terms.
• Maintain records and safeguard confidential information.
• Review payer contracts and prepare worksheets and reimbursement analyses for leadership.
• Support the creation and maintenance of a database for contractual requirements and provider obligations.
• Maintain reference guides and fee schedules; distribute updates to departments.
• Oversee vendor relationships for credentialing/licensure to prevent lapses in coverage.
• Track daily productivity; manage deadlines and priorities; coordinate meetings.

Conocimientos

Contract analysis

Payer contracting

Regulatory compliance

Attention to detail

Communication skills

Educación

High School Diploma or GED

Associate's degree or higher in Business/Healthcare admin

CPCS/CPMSM or similar certification

Herramientas

CAQH

PECOS enrollment

Microsoft Office Suite

Database software (Access or similar)

Descripción del empleo

BD is seeking a Contract Administration Supervisor to oversee application, credentialing and health plan filing processes. You will guide payor escalations, review contracts, and maintain records with strict adherence to Medicare and non-Medicare requirements.

The role requires leadership, strong contract interpretation, and collaboration with Legal, Compliance and Finance to ensure timely, compliant execution of provider agreements.