Credentialing Manager - Fully Remote Opportunity

Our practice group is looking for a resourceful team leader with versatility and adaptability that can make a difference in Credentialing.

You’ll have the opportunity to work with an organization whose brands and partners are making a difference in people’s lives every day in an environment where hard work and achievement are recognized and rewarded. We are looking for a visible handson worker who always retains a professional demeanor always and can make thoughtful decisions.

POSITION ACTIVITIES INCLUDE BUT NOT LIMITED TO:

• Initiate the credentialing/enrollment process by entering/logging/scanning information into shared drive for initial updating and add on applications and maintenance processes
• Perform provider credentialing/qualifying process to ensure all requirements are met by running required primary source verification.
• Manage small credentialing team and lead them to success
• Assist with and present reports for high level updates on organization’s credentialing status.
• Maintain updates on provider/store facing enrollment status spreadsheet.
• Partner with Central Billing Office to ensure all processes and functions are met
• Partner with Central Billing Office to assist with credentialing and A/R updates.
• Manage emails within credentialing shared email inbox.
• Assist with recredentialing every 3 years based on providers’ effective dates with commercial insurance and vision insurance plans.
• Assist Central Billing Office with aging cleanup work

EDUCATION AND WORK EXPERIENCE REQUIREMENTS:

Candidate must reside in AL AZ CO FL GA IL IN KY MI MN NE NJ OH PA TX IA or WI.

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3 years’ experience with vision and medical insurance enrollment

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Vision claims filing on vision portals experience required

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Ability to gather analyze interpret and present data in clear and concise reports and make recommendations

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Knowledge of Microsoft Excel Word and Outlook

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Ability to think logically in following procedures and instructions

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Ability to selfdirect confidently in the absence of defined/detailed instructions

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Ability to followup timely and thoroughly on outstanding tasks

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Ability to multitask and work in a fastpaced environment

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Ability to to maintain confidentiality of privileged information gained

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Highly organized

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Detail Oriented

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An effective communicator with strong oral written and persuasive skills and capability to deal with people at all levels in the organization.