Healthcare Provider Enrollment/Credentialing Manager(Northeast Ohio Territory - Remote)
About the position
The Provider Enrollment/Credentialing Manager at Medic Management Group is responsible for overseeing the payer enrollment functions and managing a team of Provider Enrollment Specialists. This role involves ensuring compliance with regulatory standards, enhancing operational efficiencies, and providing exceptional service to clients in the healthcare sector. The manager will also be involved in training staff, conducting audits, and maintaining strong relationships with medical facilities and health plan representatives.
Responsibilities
Manage a team of Provider Enrollment Specialists and support day-to-day business execution.
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Function as a coach and leader, promoting growth and accountability within the team.
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Organize provider enrollment functions to maximize departmental productivity.
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Conduct regular audits of team work and revise processes to increase operational efficiencies.
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Implement new systems focused on continuous improvement.
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Prepare and conduct meetings with internal teams and clients, including preparing agendas and minutes.
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Monitor and report turnaround times for enrollment applications, ensuring high-quality service delivery.
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Develop and prepare monthly/quarterly reports summarizing department activity.
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Conduct training sessions on various aspects of the provider enrollment process.
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Manage new practice setup and onboarding, including gathering information and setting up client folders.
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Maintain compliance with regulatory standards and build relationships with medical facilities and health plan representatives.
Requirements
High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
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5+ years of credentialing/revenue cycle experience, with at least 5 years in a supervisory or management capacity.
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Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) is favorable.
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Proven ability to train, lead, mentor, and develop subordinates.
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Knowledge in reimbursements and proficiency in specialties and ancillary services.
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Prior exposure to setting up EFT processes for Medicare and Durable Medical Equipment.
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Excellent written and oral communication skills, with strong people skills and ethical mindset.
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Ability to analyze complex data and make informed decisions.
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High proficiency with Microsoft Office products and billing platforms.
Nice-to-haves
Experience with payor enrollment platforms is viewed favorably.
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Knowledge of specific rules and guidelines for enrollment and credentialing requirements for Ohio and other states.
Benefits
Disability insurance
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Health insurance
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Dental insurance
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401(k)
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Flexible spending account
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Paid time off
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Employee assistance program
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Vision insurance
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401(k) matching
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Flexible schedule
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Life insurance
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