Credentialing Manager
Apply NowCompany: Aspire Allergy & Sinus
Location: Austin, TX 78745
Description:
Credentialing Manager
Department: Revenue Cycle
Employment Type: Permanent - Full Time
Location: Austin, TX
Reporting To: VP of Rev Cycle
Description
The Credentialing Manager is responsible for developing, managing and monitoring processes and procedures that support the Aspire Allergy & Sinus credentialing, re-credentialing, expirable data management, and delegated credentialing contract processes. Oversees all the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Supervises credentialing staff in the day-to-day management of the overall credentialing process and database management.
This position requires full-time onsite work at 5929 Balcones Dr., Austin, TX 78731.
Key Responsibilities
Responsible for ensuring Aspire Allergy & Sinus providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities in accordance with Federal and State laws and CMS accreditation standards.
Coordinates the management of the credentialing database ensuring accuracy of data and reporting to downstream systems and departments.
Coordinates the management of the electronic credentials application to ensure distribution, receipt, processing and timely delivery to health entity.
Coordinated the management of the expirable process to ensure all contracted provider licenses, certificates, insurance coverage and any other credentialing documents remain current ensuring appropriate notification prior to expiration.
Monitors and reports turnaround times for processing of credentials application, ensuring compliance with accrediting organization requirements.
Create and maintain CAQH, NPPES, PECOS and any additional platforms required for provider credentialing.
Maintain knowledge of current health plan, federal and state requirements for credentialing providers.
Conduct research and provide summaries as requested for various provider types, facilities, or payer entities.
Define and implement processes for gathering credentialing data from health care providers.
Skills, Knowledge & Expertise
Required Education and Experience:
Minimum of 5+ years of Contracting and Credentialing experience for physicians and mid-level providers in multiple states.
Familiarity with CAQH, PECOS, NPPES, license verification and credentialing software.
Work authorization/security clearance requirements:
Must be legally authorized to work in the United States.
What Benefits do we offer Aspire Employees?
Explore More About Aspire
Instagram - https://www.instagram.com/aspireallergy/
LinkedIn - https://www.linkedin.com/company/aspire-allergy/mycompany/
Aspire Allergy & Sinus is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Department: Revenue Cycle
Employment Type: Permanent - Full Time
Location: Austin, TX
Reporting To: VP of Rev Cycle
Description
The Credentialing Manager is responsible for developing, managing and monitoring processes and procedures that support the Aspire Allergy & Sinus credentialing, re-credentialing, expirable data management, and delegated credentialing contract processes. Oversees all the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Supervises credentialing staff in the day-to-day management of the overall credentialing process and database management.
This position requires full-time onsite work at 5929 Balcones Dr., Austin, TX 78731.
Key Responsibilities
Responsible for ensuring Aspire Allergy & Sinus providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities in accordance with Federal and State laws and CMS accreditation standards.
Coordinates the management of the credentialing database ensuring accuracy of data and reporting to downstream systems and departments.
Coordinates the management of the electronic credentials application to ensure distribution, receipt, processing and timely delivery to health entity.
Coordinated the management of the expirable process to ensure all contracted provider licenses, certificates, insurance coverage and any other credentialing documents remain current ensuring appropriate notification prior to expiration.
Monitors and reports turnaround times for processing of credentials application, ensuring compliance with accrediting organization requirements.
Create and maintain CAQH, NPPES, PECOS and any additional platforms required for provider credentialing.
Maintain knowledge of current health plan, federal and state requirements for credentialing providers.
Conduct research and provide summaries as requested for various provider types, facilities, or payer entities.
Define and implement processes for gathering credentialing data from health care providers.
Skills, Knowledge & Expertise
- In-depth knowledge of contracting and credentialing guidelines at a state and federal level.
- Experience working both independently and, in a team-oriented, collaborative environment.
- Highly self-motivated, directed and proactive.
- Flexible and adaptable regarding learning and understanding new technologies.
- Ability to effectively prioritize and execute timelines in a fast paced, dynamic environment.
- Highly analytical and detail oriented with strong interpersonal written and oral communication skills.
- Ability to always maintain confidentiality of privileged information.
Required Education and Experience:
Minimum of 5+ years of Contracting and Credentialing experience for physicians and mid-level providers in multiple states.
Familiarity with CAQH, PECOS, NPPES, license verification and credentialing software.
Work authorization/security clearance requirements:
Must be legally authorized to work in the United States.
What Benefits do we offer Aspire Employees?
- Medical, Dental and Vision Insurance.
- Generous Paid Time Off and 10 Paid Holidays
- Free Allergy Testing and Discounted Treatments
- 401(k) + Generous Employer Match
- Employee rewards program!
- + More!
Explore More About Aspire
Instagram - https://www.instagram.com/aspireallergy/
LinkedIn - https://www.linkedin.com/company/aspire-allergy/mycompany/
Aspire Allergy & Sinus is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.