The Credentialing Manager will be responsible for overseeing the processes performed within the Credentialing Department. These processes include but are not limited to the credentialing and re-credentialing of health care providers for SCHCPA with direction from the Director of Revenue Cycle Management. Responsibilities will include the overall management of the credentialing staff and the performance of all credentialing applications for the physicians and allied health professions both on paper and on-line applications with CAQH. In addition, this individual will be responsible for the department processes for obtaining and maintaining all certifications, licenses, CV’s and malpractice information on past claims.
Skills & Abilities:
Must be able to work in a team oriented environment
Excellent written and oral communication skills
Working knowledge of Microsoft Word and Excel
Excellent time management and organizational skills
Strong management skills
Proficiency in all applicable software / databases utilized
Familiarity and understanding of HIPAA, Joint Commission, NCQA, CMS standards and patient confidentiality regulations.
Training & Education:
Bachelor’s degree and/or equivalent work history required
Three year experience in a physician credentialing environment
One year supervisory experience.
Certified Provider Credentialing Specialist (CPCS) by the National Association of Medical Staff Services (NAMSS) required or the ability to obtain certification within one year.
Finance and Accounting
483-SCHC Pediatric - Philadelphia, PA
Shift begin time
Tenet Healthcare - 5 months ago