Job description
Transformations Care Network is an established network of behavioral health clinics that, out of a passion for providing superior patient care, is empowering our clinicians and customer service teams to provide easy access to high-quality, outcomes-based care to all those that need help, and when they need it most.
Our vision is to create a united, centralized network of accessible, multi-specialty clinics that offer immediate, superior behavioral health treatment options. We provide our employees with the opportunity to grow, learn and expand their skills! We are growing rapidly and want to talk to you about what that looks like for you and your career!
Position Summary:
The position will report to the National Director RCM and is responsible for managing the day-to-day operations of the Credentialing team. This position provides leadership and direction to the department teammates and manages the Credentialing Department functions. This position develops and implements policies and procedures and appropriate workflows to ensure credentialing is completed accurately and timely. This position also maintains and has primary responsibility for the relationships with Physician Practices and other key stakeholders as well as external contacts.
About the Role:
About You:
Benefits:
Our vision is to create a united, centralized network of accessible, multi-specialty clinics that offer immediate, superior behavioral health treatment options. We provide our employees with the opportunity to grow, learn and expand their skills! We are growing rapidly and want to talk to you about what that looks like for you and your career!
Position Summary:
The position will report to the National Director RCM and is responsible for managing the day-to-day operations of the Credentialing team. This position provides leadership and direction to the department teammates and manages the Credentialing Department functions. This position develops and implements policies and procedures and appropriate workflows to ensure credentialing is completed accurately and timely. This position also maintains and has primary responsibility for the relationships with Physician Practices and other key stakeholders as well as external contacts.
About the Role:
- Accurately complete & submit the following Provider applications (both Initial and Re-credentialing/Renewals) as required (completion of applications also includes conducting any necessary follow-up to ensure timely completion of process):
- Payer Enrollment/Credentialing
- Facility (Hospital/Dialysis Units/Other Entities)
- DEA/Medical Licensure
- Update and maintain provider demographic information in credentialing database timely and accurately
- Request and maintain updated credentialing documents from providers on an ongoing/as-needed basis and prior to any expirations to ensure there is no lapse in coverage or provider status
- Run regularly scheduled reports to address any outstanding applications, issues, and expiring information.
- Develop, implement and maintain policies and procedures that support organizational goals
- Maintain the overall relationship with Physician Practices and key stakeholders
- Ensures timely and accurate completion of all payer and provider credentialing applications, licensures, etc.
- Provide reports, presentations, and status updates
- Providing support to Credentialing Supervisor, Team Lead, Senior, and Coordinators
- Maintain current knowledge of all laws, regulations, and changes related to RCM team operations
- Attend team meetings, phone conferences, and training as needed; facilitate team meetings and phone conferences as needed
- Monitors productivity and accuracy metrics for Credentialing Team and provides coaching and feedback as needed
- Maintain knowledge of mental health billing, department policies, and procedures
- Develop and maintain positive working relationships with cross-functional teams, teammates Payor representatives, and other key stakeholders
- Other duties and responsibilities as assigned include but are not limited to:
- Work overtime with little or no notice as needed
- Attend team meetings, phone conferences, and training as needed
About You:
- Minimum 4 years of physician credentialing experience
- High school diploma
- Demonstrated leadership skills including the ability to apply critical reasoning skills to assist the team in issue resolution; Effective listening; Analytical thinking; Ability to develop & follow through with project plans; Ability to foster a positive team environment
- Accurate, detail-oriented, and able to meet tight turnaround times
- Intermediate to Advanced computer skills and proficiency in MS Word, Excel, Outlook, Database management/maintenance, and Internet usage
- Excellent written/verbal communication and customer service skills
- Ability to build effective relationships with stakeholders
- 4-6 years of physician credentialing experience
- Certified Provider Credentialing Specialist (CPCS) certification or other credentialing certification
- Previous experience in a Credentialing Leadership role
Benefits:
- Health and Dental Insurance
- PTO / Paid Time Off
- Short- and Long-Term Disability
- Life Insurance
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