Manager of Credentialing - Full Time Days

Cape Fear Valley Health; Fayetteville (NC); Sur place; USD 85 000 - 120 000; Plein temps

Résumé du poste

Cape Fear Valley Health System is seeking a Manager to oversee payer enrollment activities for employed and certain contracted providers, hospitals and group practices. This role partners with Physician Financial Services to ensure accurate enrollment, revalidations, and data integrity across NPI, PECOS and NC Medicaid systems.

The ideal candidate will drive enrollment quality, coordinate with CAQH and hospital departments, and mentor staff to maintain timely, compliant processes within the

Qualifications

• 2 years’ experience in credentialing and/or provider enrollment in a large multi-specialty health system
• Associate degree required or 4 years’ experience as a practice manager or administrator will be considered in lieu of degree
• Bachelor’s degree preferred

Responsabilités

• Coordinate enrollment activities with physician groups and hospital departments to ensure proper payment
• Work with Medical Group and Medical Staff Services to onboard providers and new groups from a payer enrollment perspective
• Collaborate with CAQH and other organizations on credentialing applications processing
• Ensure NPI registry, PECOS, NPPES and NC Medicaid data consistency for CFV entities
• Manage enrollments, reenrollments and revalidations in a timely, accurate manner
• Provide quality control to ensure staff are trained and perform duties accurately
• Perform other duties as assigned

Connaissances

Interpersonal skills

Written and verbal communication

Team player

English proficiency

Formation

Associate degree

Bachelor's degree preferred

Outils

Microsoft Word

Excel

PowerPoint

Access

Description du poste

Summary

Oversee, lead and coordinate the payer enrollment activities associated with employed and certain contracted providers, hospitals and group practices within Cape Fear Valley Health System.

Facility

Cape Fear Valley Medical Center

Location

Fayetteville, North Carolina

Department

Physician Financial Services

Job Family

Management

Work Shift

Days (United States of America)

Summary

Oversee, 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 Functions

The 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 payment
• Works closely with Medical Group and Medical Staff Services to ensure all providers and new groups are onboarded from a payer enrollment perspective
• Work with CAQH and other organizations on the processing of credentialing applications
• Ensures NPI registry, PECOS, NPPES and NC Medicaid systems have consistent information related to CFV entities
• Ensure that enrollments, reenrollments and revalidations are handled timely, accurately and consistently
• Provides quality control measures to ensure that staff are properly trained and executing functions accurately and timely
• Other duties as assigned

Minimum Qualifications

The 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 degree
• Bachelor’s degree preferred

Work Experience

• 2 years’ experience working with a large multi-specialty health system with knowledge and experience in credentialing and/or provider enrollment required

Knowledge, Skills, And Abilities Required

• Proficiency in reading, writing, and speaking the English language
• Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations
• Strong written and verbal skills, be results oriented, and exemplify a team player attitude
• Expert skills in Microsoft Word, Excel, PowerPoint and Access
• Ability and willingness to work on a variety of activities and projects
• Ability to work with people in a tactful, diplomatic manner

Physical Requirements

• Present a professional image
• Visual and auditory acuity

Required Licenses And Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity