Manager of Credentialing - Full Time Days

Facility

Cape Fear Valley Medical Center

Location

Fayetteville, North Carolina

Department

Physician Financial Services

Job Family

Management

Work Shift

Days (United States of America)

Summary

Oversee, lead and coordinate the payer enrollment activities associated with employed and certain contracted providers, hospitals and group practices within Cape Fear Valley Health System.

Major Job Functions

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:

Work with Physician groups and Hospital departments on enrollment activities to ensure proper payment

Works closely with Medical Group and Medical Staff Services to ensure all providers and new groups are onboarded from a payer enrollment perspective

Work with CAQH and other organizations on the processing of credentialing applications

Ensures NPI registry, PECOS, NPPES and NC Medicaid systems have consistent information related to CFV entities

Ensure that enrollments, reenrollments and revalidations are handled timely, accurately and consistently

Provides quality control measures to ensure that staff are properly trained and executing functions accurately and timely

Other duties as assigned

Minimum Qualifications

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

Education and Formal Training:

Associate’s degree required OR 4 years’ experience as a practice manager or administrator will be considered in lieu of degree

Bachelor’s degree preferred

Work Experience:

2 years’ experience working with a large multi-specialty health system with knowledge and experience in credentialing and/or provider enrollment required

Knowledge, Skills, and Abilities Required:

Proficiency in reading, writing, and speaking the English language

Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations

Strong written and verbal skills, be results oriented, and exemplify a team player attitude

Expert skills in Microsoft Word, Excel, PowerPoint and Access

Ability and willingness to work on a variety of activities and projects

Ability to work with people in a tactful, diplomatic manner

Physical Requirements:

Present a professional image

Visual and auditory acuity

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity