6 Assistant Director of Credentialing Jobs in Columbus, GA
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Assistant Director of Credentialing
$65k-81k (estimate)
Full Time | Ambulatory Healthcare Services
2 Days Ago
Hughston is Hiring an Assistant Director of Credentialing Near Columbus, GA
Position GoalServe as a key member of the Credentialing Team, which includes both privileging and payor enrollment, by maintaining up-to-date knowledge of external partners policies and procedures to facilitate efficient and effective Credentialing processes for Hughston and its affiliated providers. Collaborate with internal stakeholders to ensure effective communication.
Position Responsibilities
ExperienceRequired:
Position Responsibilities
- Assist the System Director of Credentialing in overseeing the credentialing process for the organization and all healthcare providers; to include JHMH, HSC and Valdosta Surgery Center.
- Oversee the maintenance of industry standards and regulations.
- Maintain best practices for payer enrollment and ensure communication of changes to relevant stakeholders.
- Assist in the development of credentialing policies and procedures.
- Provide day-to-day guidance to Credentialing Teams: Payor Enrollment and Privileging.
- Review and maintain payor provider directories.
- Collaborate with the Billing Department to ensure successful reimbursement of claims submitted to payors related to enrollment activities.
- Collaborate with sister departments (Revenue Integrity and Managed Care) to facilitate efficient credentialing process.
- Ensure accurate and up-to date provider data is maintained in digital platforms (i.e. Athena/Verity)
- Establish and maintain strong relationships with external stakeholders to facilitate smooth communication and problem resolution.
- Provide support and education to the Credentialing Teams regarding processes and requirements.
- Provide ongoing assessment to ensure compliance with The Joint Commission, Medicare COP and AAAHC standards.
- Conduct regular audits to ensure ongoing compliance with credentialing standards and accurate enrollments.
- Facilitate processes to allow for increased efficiency of the payor enrollment process.
- Ensure maintenance of all CAQH/PECOS/NPPES profiles for all providers.
- Complete and coordinate paperwork for ERA, EDI, EFT, and other electronic channels between the organization and payers in the electronic billing system, and with enrollment services.
- Ensure all credentialing processes are completed timely to prevent any lapse in enrollment or appointment.
- Monitor for trends in enrollment process completion to establish timely resolution and eliminate delays.
- Manages credentialing department staff. Provides direction necessary feedback, job performance reviews and approves and monitors time.
ExperienceRequired:
- Three years of credentialing and/or payor enrollment experience in a healthcare setting
- 1 year management experience
- Associate degree or higher in related field
- Provider Enrollment Specialist Certification (PESC).
- Strong knowledge of credentialing standards, regulations, and processes
- Ability to work independently with minimal supervision.
- Requires skill in computer systems and applications.
- Must have outstanding organizational
- Must have outstanding communication skills (oral/written).
- Must be able to prioritize work to meet deadlines despite frequent interruptions.
- Exceptional attention to detail and high level of accuracy.
- Ability to work in a team environment.
- Must be able to prioritize tasks and use good professional judgment in assigned dutie
- Must have a valid driver’s license and a satisfactory Motor Vehicle Record (MVR)
Job Summary
JOB TYPE
Full Time
INDUSTRY
Ambulatory Healthcare Services
SALARY
$65k-81k (estimate)
POST DATE
06/26/2024
EXPIRATION DATE
12/17/2024
WEBSITE
hughston.com
HEADQUARTERS
PHENIX CITY, AL
SIZE
200 - 500
FOUNDED
1949
TYPE
Private
CEO
MARK BAKER
REVENUE
$50M - $200M
INDUSTRY
Ambulatory Healthcare Services
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About Hughston
Hughston is a provider of advanced orthopedic services and musculoskeletal trauma, sports injuries, spine and upper extremity treatments.
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