Medical Credentialing Supervisor
USA Vein Clinics, Mexico
Job Description
We are growing! USA Vein Clinics, Vascular Centers, and Fibroid Centers are looking to add a Medical Credentialing Supervisor to our team. As the Medical Credentialing Supervisor you would be responsible for overseeing the credentialing and re-credentialing process for all providers in 80+ clinics across 14 states.
Essential Duties and Responsibilities:
1. Processes physician accreditation, managed care, governmental and commercial insurance enrollment and re-credentialing
2. Responsible for daily provider data management and review of credentialing files for accuracy and completeness, utilizing internal and external sources
3. Responsible for analyzing clinic utilizations and develop physician location scheduling recommendations
4. Analyze local payor IPA markets for partnerships or payer contracting opportunities
5. Performs primary source verification via various state and national sources
6. Maintains individual provider credential files with all the appropriate documentation consistent with AAAHC and NCQA standards
7. Oversees, updates and maintains provider credential database including CAQH, PECOS, NPPES Registry, Sharepoint any other applicable regulatory agencies
8. Develops and prepares analytical reports monthly/quarterly of the summary of credentialing activity
9. Responds timely to provider inquiries by letter, phone or internal communication
10. Work closely and maintain relationships with provider relations at each payer, and communicates any challenges and/or concerns with manager timely
11. Maintain Credentialing Applications for accuracy and completeness
12. Work to develop automation Bots to streamline the applications/Enrollment process
Requirements
- Negotiation of contracts and fee schedules
- Familiarity with medical terminology through education or relevant work experience*
- Strong computers skills and typing skills; 35+ wpm
- Immaculate attention to detail and excellent proofreading skills
- Strong Analytical and data manipulation skills
- Excellent organizational skills
- Experience with credentialing of different medical specialties
- Advanced computer and analytical skills,
- Must be team player with strong work ethic, discipline
Benefits
- IMSS 100%
- Vacations (after the first year)
- Christmas bonus
- Paid Training
- Weekends off
- Mexican Holidays off
You will also be eligible for any additional employee benefits that the company may provide in the future.