Strategic Credentialing & Enrollment Manager

capefearvalley; United States; On-site; USD 85,000 - 110,000; Full time

Job summary

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

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 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

Responsibilities

• 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

Skills

Interpersonal skills

Written communication

Verbal communication

Team player

English proficiency

Education

Associate degree

Bachelor's degree (preferred)

Tools

MS Word

MS Excel

MS PowerPoint

MS Access

Job description

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