What are the responsibilities and job description for the Contracting & Credentialing Supervisor position at Accelerated Urgent Care?
About Us:
Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career growth; 65% of our Administration and Management team members have been internal candidates! 16 clinics strong across 5 regions in California and growing! Our Core Values: Friendliness, Competence, Respect, Teamwork, Compassion, Hard work, Integrity, Humility, Dedication!
Job Overview:
The Contracting & Credentialing (C&C) Supervisor, under the supervision of the Billing Manger, working under the Director of Finance & Billing, is responsible for overseeing all provider and facility licensing, credentialing, and contracting across all applicable regions and health plans, including supervision of Contracting & Credentialing Specialists and/or Coordinators. The Contracting & Credentialing Supervisor will work cooperatively with many teams including Billing, HR, Recruiting, Providers, Operations, and the Owners, to ensure timely and accurate contracting and credentialing to meet staffing and facility needs in a rapidly growing organization.
Essential Responsibilities:
Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career growth; 65% of our Administration and Management team members have been internal candidates! 16 clinics strong across 5 regions in California and growing! Our Core Values: Friendliness, Competence, Respect, Teamwork, Compassion, Hard work, Integrity, Humility, Dedication!
Job Overview:
The Contracting & Credentialing (C&C) Supervisor, under the supervision of the Billing Manger, working under the Director of Finance & Billing, is responsible for overseeing all provider and facility licensing, credentialing, and contracting across all applicable regions and health plans, including supervision of Contracting & Credentialing Specialists and/or Coordinators. The Contracting & Credentialing Supervisor will work cooperatively with many teams including Billing, HR, Recruiting, Providers, Operations, and the Owners, to ensure timely and accurate contracting and credentialing to meet staffing and facility needs in a rapidly growing organization.
Essential Responsibilities:
- Supervise all essential functions performed by C&C Specialists and C&C Coordinators.
- Oversee day to day activities of staff who process credentialing and recredentialing applications for health care providers.
- Daily monitoring of employee’s workload and various credentialing workflows (i.e. onboarding, credentialing, EPCS and e-prescribe, enrollments).
- Ensure all C&C tasks and duties have a corresponding Standardized Operating Procedure (SOP).
- With guidance from the Billing Manager and Director of Finance, Billing, C&C, interview, hire, and train new staff on credentialing and recredentialing policies and procedures; also provide ongoing training as needed regarding new guidelines or updated processes and policies.
- Play an important role in making decisions regarding employee’s performance issues such as the need for disciplinary coaching, performance documentation and/or termination.
- Implement department procedures to facilitate organized and up to date provider databases.
- Conduct periodic audits of credentialing files and staff deliverables.
- Administer system for tracking license and certification expirations to ensure renewals are submitted in a timely manner.
- Monitor external credentialing databases including CAQH, PECOS, and other agencies to ensure data is updated and ready for quick retrieval.
- Supervise application processes to ensure they are properly verified and accurately uploaded into an online credentialing database system.
- Resolve complex questions regarding credentialing or provider database maintenance and best practices.
- Prepare and/or oversee reports on applications and credentialing statuses to identify trends and improve the credentialing process.
- Supervise all provider and facility licensing, credentialing, and contracting necessary to ensure claims are paid and cash flow is not disrupted.
- Develop and oversee licensing, credentialing, and contracting workflows and processes as we scale our clinical team across California and potentially other states.
- Supervise maintenance and accuracy of tracking databases of required provider and facility licenses, certifications, contract statuses, and credentials; in addition, review critical data and the associated documents on an ongoing basis to ensure compliance.
- Supervise C&C Specialists/Coordinators to ensure AUC’s provider roster to mitigate risks associated with growth, drive efficiencies, and advance proactive monitoring and action related to licensing, credentialing, and contracting.
- Oversee and communicate provider and plan statuses, along with barriers related to operational processes, and drive solutions to overcome challenges.
- Ensure contracting and credentialing support is readily provided to various departments, teams, and individuals within the organization as needed to fulfill business needs.
- Partner with various health plan representatives to promptly follow up and execute provider and plan approval dates.
- Track and monitor all executed health plan agreements, work with the Billing Manager to ensure claims are billed correctly per the executed agreements.
- Work directly with the Billing Manager to ensure new health plan contracts and their associated effective dates are communicated to the appropriate Operations Managers for staff notification and education purposes.
- Oversee the communication of new providers as they are onboarded to the Billing Team, to ensure claim reimbursements are maximized.
- Supervise new provider credentialing which includes sending welcome emails to new providers, in addition be of assistance for any questions or concerns they may have. Trouble shoot barriers quickly to avoid delays in receiving credentialing approvals.
- Supervise the professional liability application process, ensure the application and approval process is efficient and timely.
- Oversee the Supervising Physician matrix along with the associated agreements, to remain in compliance with the Medical Board and health plan requirements.
- Oversee submission of Letters of Intent to health plans or medical groups that we are not yet contracted with; educate and build relationships with health plan groups to help expedite the contracting process.
- Supervise the contracting and credentialing of all new facilities, to ensure new clinics are contracted by their assigned go live date.
- Perform special projects and other duties as requested.
- Perform other duties as assigned.
- Comply with departmental policies and procedures.
- Responsible for showing up to work on time and being available to all team members including HR, Billing, and Providers during work hours.
- Work well with all AUC staff members.
- Provide personal commitment and ownership to enhance knowledge, skills, and abilities in healthcare contracting, credentialing, and compliance.
- Maintain patient confidentiality and information security, adhere to all HIPAA regulations and requirements.
- Follow and adhere to CDC requirements for healthcare facilities.
Position Type: Full-time, Non-Exempt
Position Hours: Monday through Friday, 8am – 5pm
Job Type: Full-time
Benefits: Medical, Dental, Vision, Life and PTO Stocked Coffee Bar
***COVID-19 considerations: Our team follows and adheres to CDC requirements
Position Hours: Monday through Friday, 8am – 5pm
Job Type: Full-time
Benefits: Medical, Dental, Vision, Life and PTO Stocked Coffee Bar
***COVID-19 considerations: Our team follows and adheres to CDC requirements
