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Credentialing Process Manager
2 weeks ago
About Us:
We are a rapidly growing health tech startup with a mission to revolutionize healthcare through innovative mobile technology solutions.
Our mobile apps empower healthcare professionals and patients alike to make informed decisions, streamline processes, and improve patient outcomes.
Job Responsibilities:
- Manage the entire credentialing process for healthcare providers from initial applications to ongoing maintenance and re-credentialing.
- Submit enrollment applications to various insurance carriers and government agencies.
- Verify and maintain accurate provider information including licenses, certifications, and insurance policies.
- Maintain organized records of credentialing documents, expirations, and updates.
- Stay up-to-date with industry regulations and insurance requirements to ensure provider compliance.
- Liaise with insurance companies, healthcare providers, and relevant parties to resolve credentialing issues and inquiries.
- Collaborate with the RCM staff to resolve issues related to provider credentialing.
Key Performance Indicators (KPIs):
- Application Processing Time: Submit applications within 24-48 hours of request.
- Application Accuracy: Aim for 95–100% accuracy.
- Application Approval Rate: Achieve a 95% approval rate on first submission.
