Credentialing Team Leader

1 week ago


Knoxville, Tennessee, United States Helen Ross McNabb Center Full time
Credentialing Team Leader Job Description

Job Summary:

The Credentialing Team Leader is responsible for leading the credentialing department, ensuring that clinical providers meet all requirements to secure reimbursement for services provided on behalf of the Center. This role involves managing databases, rosters, and internal/external checks to guarantee staff are cleared and rostered in a timely manner.

Key Responsibilities:

  • Coordinate internal and external credentialing requirements for all licensed providers, following policy, procedures, and guidelines for insurance companies.
  • Supervise team of credentialists to achieve successful credentialing services for the Center's providers.
  • Work closely with other departments, including Financial Services, Utilization Management, and Information Technology.
  • Facilitate semi-annual Humana credentialing audits and maintain National Provider Database for all credentialed staff.
  • Complete BESMART enrollments for appropriate credentialed staff and attend informational conferences related to credentialing procedures.

Requirements:

  • Bachelor's degree in human services or business field and 3 years of HR/credentialing experience.
  • At least 3 years of related credentialing or HR experience.
  • Computer experience in a healthcare setting required.
  • Knowledge of medical billing and human resource policies preferred.

Working Conditions:

This position operates primarily out of an administrative office with limited visits to clinics or other offices.

Compensation:

Starting salary for this position is approximately $21.25/hour based on relevant experience and education.

Location:

Knoxville, Tennessee



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