Manager of Credentialing - Full Time Days

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 72,000 - 100,000; Full time

Job summary

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Payer Enrollment Manager to oversee enrollment activities for employed and certain contracted providers and groups. You will coordinate payer enrollment, onboarding, and credentialing processes in collaboration with Medical Group, Medical Staff Services, and CAQH.

The role requires strong knowledge of credentialing systems (NPI/PECOS/NC Medicaid), excellent communication, and leadership to train staff and ensure timely enrollments

Qualifications

• Associate’s degree required or 4 years’ experience in practice management/administration.
• Experience with credentialing and provider enrollment in a large health system.
• Strong written and verbal English communication; team oriented and results driven.

Responsibilities

• Oversee enrollment activities for employed and selected contracted providers and groups to ensure proper payment.
• Coordinate onboarding of providers and new groups from a payer enrollment perspective with Medical Group and Medical Staff Services.
• Work with CAQH and other organizations on credentialing applications processing.
• Ensure NPI, PECOS, NPPES and NC Medicaid data are consistent across CFV entities.
• Provide quality control and training to staff to ensure timely, accurate enrollment and revalidations.

Skills

Payer enrollment

Credentialing

Communication

Team leadership

Microsoft Office proficiency

Education

Associate’s degree

Bachelor’s degree preferred

Tools

CAQH

NPI registry

PECOS

NC Medicaid systems

NPPES

Job description

FacilityCape Fear Valley Medical CenterLocationFayetteville, North CarolinaDepartmentPhysician Financial ServicesJob FamilyManagementWork ShiftDays (United States of America)SummaryOversee, lead and coordinate the payer enrollment activities associated with employed and certain contracted providers, hospitals and group practices within Cape Fear Valley Health System.Major Job FunctionsThe following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:Work with Physician groups and Hospital departments on enrollment activities to ensure proper paymentWorks closely with Medical Group and Medical Staff Services to ensure all providers and new groups are onboarded from a payer enrollment perspectiveWork with CAQH and other organizations on the processing of credentialing applicationsEnsures NPI registry, PECOS, NPPES and NC Medicaid systems have consistent information related to CFV entitiesEnsure that enrollments, reenrollments and revalidations are handled timely, accurately and consistentlyProvides quality control measures to ensure that staff are properly trained and executing functions accurately and timelyOther duties as assignedMinimum QualificationsThe following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:Education and Formal Training:Associate’s degree required OR 4 years’ experience as a practice manager or administrator will be considered in lieu of degreeBachelor’s degree preferredWork Experience:2 years’ experience working with a large multi-specialty health system with knowledge and experience in credentialing and/or provider enrollment requiredKnowledge, Skills, and Abilities Required:Proficiency in reading, writing, and speaking the English languageExcellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizationsStrong written and verbal skills, be results oriented, and exemplify a team player attitudeExpert skills in Microsoft Word, Excel, PowerPoint and AccessAbility and willingness to work on a variety of activities and projectsAbility to work with people in a tactful, diplomatic mannerPhysical Requirements:Present a professional imageVisual and auditory acuityRequired Licenses and CertificationsCape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity