Key skills
SalesforceLeadershipCommunicationCollaboration
About this role
Role Overview
- Responsible for working on the day-to-day requirements of Payer Credentialing and Enrollments.
- Determine without guidance what needs to be worked on and prioritized.
- Partner with the team lead to focus on optimizing revenue, standardizing processes, building and maintaining strong payer relationships, and ensuring positive internal and external client experiences.
- Holding a major role of responsibility with a high-performing payer credentialing team, fostering a culture of accountability, collaboration, and continuous improvement.
- Continuously evaluate and improve existing payer enrollment processes and systems, leveraging technology, vendors, and best practices to enhance quality and productivity.
- Monitor industry trends and regulatory changes to proactively adjust processes and ensure continued compliance.
- Comply with all State and Federal Laws regarding an effective Compliance Program, inclusive of HIPAA Privacy and Security.
- Adhere to the organization's Code of Conduct and be familiar with all compliance policies and procedures relevant to this position.
- Hold oneself accountable for completing all activities in a timely manner.
Requirements
- Bachelor's degree, required.
- Demonstrated success in credentialing.
- Exceptional problem-solving skills and the ability to think strategically and execute operational initiatives.
- Strong communication, interpersonal, and leadership skills, with the ability to effectively manage cross-functional relationships.
- Proven track record in managing provider data management systems, client, and payer relationships.
- In-depth knowledge of credentialing processes, regulatory requirements, and healthcare industry standards.
- 5-7 years of Credentialing Management experience in a managed care or healthcare environment. Laboratory credentialing experience is required.
- Proficiency with MS Office, Adobe Acrobat, Google Workspace, and Salesforce applications. Monday.com, and Smartsheet software knowledge is a plus.
Benefits
- Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents.
- Free testing in addition to fertility care benefits.
- Pregnancy and baby bonding leave.
- 401k benefits.
- Commuter benefits.
- Generous employee referral program.