What are the responsibilities and job description for the Assistant Payor Relations Manager position at Hopebridge?
Essential Functions
• Cultivate and maintain strong relationships with payors, ensuring compliance with multi-state ABA regulations and contractual obligations.
• Oversee and manage payor contracts, ensuring alignment with organizational goals and compliance requirements.
• Manage all credentialing processes for clinical providers in accordance with accreditation standards, Federal, and State laws and insurance requirements.
• Oversee the credentialing process and monitors critical data for extensive analysis and report generation as needed.
• Oversee the supervision of department personnel, which includes work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; assists with evaluation of performance and offers recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
• Maintains all cross training of states with credentialing specialist as well as training all new staff
• Monitor and assist with maintaining all backlog of unsubmitted and pending records in additional states as needed
• Assist with research on credentialing issues with insurance companies when entering new states and questions regarding current states
• Ensures compliance with all federal, state and local employment laws
• Performs other related duties as required and assigned
• Maintain a clear criminal record
Competencies
• Credentialing Expertise & Knowledge
• Business Acumen
• Communication
• Consultation
• Cultural Awareness
• Leadership & Navigation
• Relationship Management
• Time Management
• Attention to Detail
• Ability to follow processes and procedures
Required Education and Experience
• High School Diploma or GED
Preferred Education and Experience
• Associates or bachelor’s degree
• Knowledge of credentialing
• Previous experience working in healthcare
• Working knowledge and understanding of provider enrollment
