Job description

Job description

Credentialing Manager
Full-time/Exempt

Salary Ranges: $65,000 - $70,000

Benefits:

• 401(k)
• 401(k) matching
• Employee assistance program
• Medical, Dental, and Vision insurance
• Life insurance
• Paid time off (vacation and sick)
• 9 paid holidays
• Professional development assistance

Celebrating Life Community Health Center (CLCHC) is a faith-based nonprofit community clinic dedicated to providing high-quality, low-cost healthcare to more than 10,000 women, men, and children. Founded in 2018, CLCHC is a Federally Qualified Health Center look-alike with 75+ employees and volunteers and an annual budget of $15 million. We are currently seeking a Credentialing Manager to join our team in 2023, so if you have a passion for making a difference in the community, and love manage provider credentialing, Celebrating Life Community Health Center could be the opportunity you are looking for. Please visit our website at www.clchc.org for additional information on CLCHC.

We are looking to hire an organized credentialing manager to assist us with administrative tasks pertaining to our practitioners' credentialing. The credentialing manager will organize, maintain, and verify all aspects of the process, and maintain current files on practitioners. You will track the expiration of certifications to maintain up-to-date files, and assist health plan providers and customers with phone inquiries.

Responsibilities:

· Serve as company liaison with 3rd party payors;

· Manage and update credentialing & clinic licensure policies and protocols;

· Ensure reports on credentialing status of providers is up to date and accurate;

· Define and implement processes to ensure credentialing is completed and up to date in a timely manner, and according with HRSA compliance;

· Manage process of negotiating new insurance contracts;

· Ensure all clinic information is accurate within 3rd party payor directory;

· Drive and implement seamless protocols for gathering credentialing data from health care providers.

· Verify professional licensures to meet the requirements of our delegated insurance contracts;

· Completes background checks, licensure verifications and education verifications for clinician as required;

· Obtains and conveys information to applicants and clients as appropriate;

· Assist supported offices and administration with Explanation of Benefits, Claims, and other insurance related issues;

Requirements:

· Ability to work independently and proactively in a fast-paced, dynamic environment;

· Highly self-motivated, directed and proactive;

· Flexible and adaptable in regard to learning and understanding new technologies;

· Able to communicate effectively within department and with members of interdisciplinary teams;

· Demonstrates ability to lead, manage and motivate teams;

· Ability to effectively prioritize and execute tasks in a high-pressure environment;

· Highly analytical and detail-oriented with ability to demonstrate command of details and to articulate those details at a higher level;

· Strong interpersonal, written, and oral communication skills;

· Experience working both independently and, in a team-oriented, collaborative environment;

· Keen attention to detail;

· Ability to interact with internal and external customers;

· In depth knowledge of credentialing;

· Proven analytical and problem-solving abilities;

· Experience with credentialing software preferred;

· Assist providers with CAQH ProView profile registration and maintenance

· Knowledge of Medicare 855, 855A, and 855R applications

· Knowledge of Medi-Cal enrollment

· Knowledge of PAVE Provider Portal

· Knowledge of VerityStream

· Bachelor’s degree or higher;

Job Type: Full-time

Pay: $65,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
All patients are required to wear a mask

Work Location: One location

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