Manager of Credentialing - Full Time Days

capefearvalley; United States; Presencial; USD 85.000 - 110.000; Jornada completa

Descripción de la vacante

Cape Fear Valley Health System is seeking a Manager in Physician Financial Services to oversee payer enrollment for employed and contracted providers and hospitals within the CFV Health System. You will lead enrollment activities to ensure proper payments and accurate data.

Responsibilities include coordinating with CAQH and other organizations for credentialing, ensuring NPI, PECOS, NPPES data consistency, timely revalidations, and staff training to maintain high accuracy in enrollment

Formación

• 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 with a large multi-specialty health system with credentialing and/or provider enrollment required
• Knowledge of English: reading, writing, and speaking proficiently
• Excellent interpersonal, written, and verbal communication skills
• Expert skills in Microsoft Word, Excel, PowerPoint and Access

Responsabilidades

• Oversee, lead and coordinate payer enrollment activities for employed and certain contracted providers, hospitals and group practices
• Work with physician groups and hospital departments on enrollment activities to ensure proper payment
• Collaborate with Medical Group and Medical Staff Services to onboard providers from a payer enrollment perspective
• Coordinate processing of credentialing applications with CAQH and other organizations
• Ensure NPI registry, PECOS, NPPES and NC Medicaid data are consistent across CFV entities
• Ensure enrollments, reenrollments and revalidations are timely and accurate
• Provide quality control to ensure staff are trained and executing functions correctly
• Perform other duties as assigned

Conocimientos

Interpersonal skills

Written communication

Verbal communication

Team player

English proficiency

Educación

Associate degree

Bachelor's degree (preferred)

Herramientas

MS Word

MS Excel

MS PowerPoint

MS Access

Descripción del empleo

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

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

• 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

Equal Opportunity Employer

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