What are the responsibilities and job description for the Credentialing Manager position at Aspire Allergy & Sinus?
Credentialing Manager
Department : Revenue Cycle
Employment Type : Permanent - Full Time
Location : Austin, TX
Reporting To : VP of Revenue Cycle Management
Description
The Credentialing Manager is responsible for developing, managing and monitoring processes and procedures that support the Aspire Allergy & Sinus credentialing, re-credentialing, expirable data management, and delegated credentialing contract processes. Oversees all the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Supervises credentialing staff in the day-to-day management of the overall credentialing process and database management.
This role is fully onsite.
What You'll Be Doing
- Responsible for ensuring Aspire Allergy & Sinus providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities in accordance with Federal and State laws and CMS accreditation standards.
- Coordinates the management of the credentialing database ensuring accuracy of data and reporting to downstream systems and departments.
- Coordinates the management of the electronic credentials application to ensure distribution, receipt, processing and timely delivery to health entity.
- Coordinated the management of the expirable process to ensure all contracted provider licenses, certificates, insurance coverage and any other credentialing documents remain current ensuring appropriate notification prior to expiration.
- Monitors and reports turnaround times for processing of credentials application, ensuring compliance with accrediting organization requirements.
- Create and maintain CAQH, NPPES, PECOS and any additional platforms required for provider credentialing.
- Maintain knowledge of current health plan, federal and state requirements for credentialing providers.
- Conduct research and provide summaries as requested for various provider types, facilities, or payer entities.
- Define and implement processes for gathering credentialing data from health care providers.
Who You Are
Required Education and Experience :
Benefits & Perks
We are a collective unit of passionate people who have come together to reinforce our cause : curing patients who suffer from allergy and sinus problems . We take great pride in hiring enthusiastic, talented individuals who believe in our cause and want to grow our company and its employees.
We recognize that we thrive and achieve advanced patient care because of our ever-growing team. We are better together and there has never been a better time to help make a difference! Aspire currently stretches among numerous clinics throughout Arizona, Colorado, Florida, New Mexico, and Texas, with plans for several more additions. Do not miss out on the lifetime opportunity to help Aspire scale up and reach more patients in more states.
