Hybrid Credentialing Lead for Payor Contracts

Caravel Autism Health, LLC; Green Bay (WI); Híbrido; USD 60.000 - 82.000; Jornada completa

Descripción de la vacante

Caravel Autism Health, LLC is seeking a Credentialing Specialist for our Green Bay, WI office. This hybrid role requires local presence for occasional on-site work and collaboration with payors and providers.

The successful candidate will manage credentialing activities, review new payor contracts, maintain relationships with payor contacts, and support cross-departmental initiatives to streamline operations.

Formación

• Bachelor’s degree in a healthcare or business-related discipline, or equivalent experience
• Certification is a plus
• At least three years of medical insurance, billing or claims experience, preferably in a supervisory capacity
• Knowledge of medical billing and ICD-10, and CPT coding
• Strong interpersonal and leadership skills
• HIPAA privacy and security knowledge

Responsabilidades

• Works with payors to add new locations to existing contracts.
• Maintains good working relationships with payor contacts.
• Performs initial review of new payor contracts and suggests changes to discuss with Director.
• Acts as a credentialing resource for providers.
• Ensures department operations are performed in an accurate and timely manner.
• Identifies and suggests process improvement goals to support operations.
• Develops and maintains partnerships across all other departments, partners, and vendors to support business objectives.
• Performs other duties as assigned.

Descripción del empleo

Caravel Autism Health, LLC is seeking a Credentialing Specialist for our Green Bay, WI office. This hybrid role requires local presence for occasional on-site work and collaboration with payors and providers.

The successful candidate will manage credentialing activities, review new payor contracts, maintain relationships with payor contacts, and support cross-departmental initiatives to streamline operations.