Provider Credentialing and Enrollment Manager

3 weeks ago

Southfield, United States EPIC Health System LLC Full time
Job DescriptionJob Description

Summary:

The Provider Credentialing and Enrollment Manager is responsible for managing and supporting the administrative and operational aspects of all provider and payer credentialing and enrollment.

This position serves as a subject matter expert by providing guidance and problem/issue resolution to internal colleagues on matters impacting projects and day-to-day activity. Strong relationship, communication, analytical and evaluative skills, and the ability to contribute to and provide primary accountability for managing/leading small projects or portions of projects is expected. Assignments may require interfacing with gathering information from and making presentations to various levels of management and internal or external executive leaders.

Essential Duties and Responsibilities:

  • Bachelor degree preferred, Associate degree required.
  • Minimum of five (5) years of progressively responsible operational or consulting experience in provider credentialing and enrollment.
  • Negotiation of contracts and fee schedules experience, preferred.
  • Knowledge and experience of the healthcare industry or medical financial operations.
  • Possess ability to identify patterns and conduct root cause analysis.
  • Communicate credentialing related claims issues.
  • Verify and renew professional qualifications, licenses, certifications, and other relevant credentials.
  • Maintain accurate and up-to-date provider credentialing information in the database.
  • Strong attention to detail and organizational skills. Demonstrated ability to manage multiple, concurrently running projects and adapt to changing deadlines, competing priorities and unexpected assignments.
  • Must be comfortable operating in a collaborative, shared leadership environment.

Skills Required:

  • Ability to understand, analyze and interpret complex documents.
  • High level of understanding of physician billing.
  • Proven ability to work with and present concepts to a wide range of audiences.

To Learn more about EPIC Health Systems please visit www.epichs.org



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