Team Lead- Credentialing

Requirements

The Team Leader will perform the functions outlined below:

Maintain individual provider files to include up to date information needed to complete the required payer credentialing applications

• Update each provider s CAQH database file timely according to the schedule
  
• Complete re validation requests issued by payers
  
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
  
• Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
  
• Need to fill applications for federal and commercial payers
  

Lead and drive the team for continuous improvement towards set targets
and manage Customer Satisfaction and Billing Efficiency
Monitor agents performance and updating their medical billing records on a
regular basis. This will include regular call monitoring of all phone reps.
Coach, guide and train team members by providing creative ideas and
ways on how to carry out the respective tasks towards providing quality
output.
Demonstrate fortitude to get things done: Is disciplined and organized. Is
able to effectively prioritize and reprioritize own work and acts with a sense
of urgency.
Developing Others: Is able to invest in the future of their team members by
developing them.
Hiring, selection and training new members.
Conduct quality assurance activities and perform payment analysis.
Can lead business review with clients & internal stakeholders.
Disciplinary measures taken on an as-needed basis, as well as carefully
managing attendance.

Benefits

• College Level
  
• Highly analytical and driven to achieve objectives
  
• Must have at least 3 years of Supervisory experience in a Healthcare- Patient Service (Medical Billing account)
  
• Capable of driving KPIs while maintaining Service Levels
  
• Preferred candidatehas worked on provider enrollment or credentialing department in a Healthcare account
  
• Haveknowledge on end to end credentialing process
  
• Preferably have worked on CAQH platform
  
• Preferably have worked on PECOS- Online enrollment management system for (Medicare Medicaid) payers
  
• Experienced applicationfilling for commercial and Federal payers
  
  

The Team Leader will perform the functions outlined below: Maintain individual provider files to include up to date information needed to complete the required payer credentialing applications Update each provider s CAQH database file timely according to the schedule Complete re validation requests issued by payers Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid Need to fill applications for federal and commercial payers Lead and drive the team for continuous improvement towards set targets and manage Customer Satisfaction and Billing Efficiency Monitor agents performance and updating their medical billing records on a regular basis. This will include regular call monitoring of all phone reps. Coach, guide and train team members by providing creative ideas and ways on how to carry out the respective tasks towards providing quality output. Demonstrate fortitude to get things done: Is disciplined and organized. Is able to effectively prioritize and reprioritize own work and acts with a sense of urgency. Developing Others: Is able to invest in the future of their team members by developing them. Hiring, selection and training new members. Conduct quality assurance activities and perform payment analysis. Can lead business review with clients & internal stakeholders. Disciplinary measures taken on an as-needed basis, as well as carefully managing attendance.