Manager, Provider Credentialing Specialist

6 days ago


Fort Myers, Florida, United States DNA Comprehensive Therapy Services LLC Full time
About the Role

We are seeking a highly skilled and experienced Credentialing Manager to join our team at DNA Comprehensive Therapy Services LLC. As a key member of our operations team, you will be responsible for overseeing the credentialing process for our providers, ensuring compliance with regulatory requirements and maintaining accurate records.

Key Responsibilities
  • Credentialing Process Management: Coordinate the management of our credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems.
  • Electronic Credentialing Applications: Manage the electronic credentialing applications, ensuring distribution, receipt, processing, and timely delivery to payers.
  • License and Certificate Management: Coordinate the management of the expirable process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
  • Turnaround Time Monitoring: Monitor and report turnaround times for processing of credentialing applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, in the least amount of time.
  • Credentialing Audits: Prepare for and coordinate credentialing audits in compliance with our delegated credentialing contracts.
  • Supervision and Training: Oversee the supervision of personnel, which includes work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; evaluate performance and make recommendations for personnel actions; motivate employees to achieve peak productivity and performance.
Requirements
  • Experience: 5 years of experience in Behavioral Health provider credentialing, with 3 years of management experience in credentialing.
  • Knowledge and Skills: Knowledge of delegated credentialing workflows, understanding of HIPAA regulations, ability to supervise and train employees, working knowledge of all major payers, ability to work under pressure while successfully meeting deadlines, positive attitude, excellent organization, time management, and prioritization skills, research capabilities, proficiency with Microsoft Office suite, strong attention to detail and speed, exceptional ability to follow oral and written instructions, high degree of flexibility and professionalism, excellent organizational skills, outstanding communications skills.
  • Education: Bachelor's degree in healthcare management, Business Management, or related field.
  • Software Experience: Experience with Athena practice management system.


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