Medical Staff Credentialing Supervisor jobs in Delaware
Medical Staff Credentialing Supervisor oversees day-to-day activities of staff that process credentialing and recredentialing applications for health care providers. Implements department procedures to facilitate organized and up-to-date provider databases. Being a Medical Staff Credentialing Supervisor administers system for tracking license and certification expirations to ensure renewals are submitted in a timely fashion. Ensures that applications are properly verified and accurately uploaded into an online credentialing database system. Additionally, Medical Staff Credentialing Supervisor resolves complex questions regarding credentialing or provider database maintenance and best practices. Prepares reports on applications and credentialing status to identify trends and improve the credentialing process. May require a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a manager. The Medical Staff Credentialing Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be a Medical Staff Credentialing Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
Recently Added Medical Staff Credentialing Supervisor jobs
Credentialing Specialist
- Bayhealth
-
Dover, DE
FULL_TIME
-
655 Bay Rd, Suite J
STATUS: Full Time 80 Hours
SHIFT: Days
General Summary:
The Credentialing Specialist (BHMG) accurately maintains demographic data in the provider enrollment/credentialing software for Bayhealth Medical Group providers; completes provider enrollment applications, follows up with health plans to expedite participation approval by each health plan, assists insurance personnel with resolving provider enrollment denials, and communicates provider enrollment status to appropriate personnel. The Credentialing Specialist also works with Medical Staff Services personnel in processing credentialing requests for Bayhealth Medical Group (BMG) providers.
Responsibilities:- Perform CAQH (Council for Affordable Quality Healthcare) re-attestations.
- Coordinate with the medical billing service company to enter referring physicians’ information into AR system.
- Obtain new provider’s CV, demographic data, and required documents for enrollment/credentialing purposes. Enter and maintain this data in the provider enrollment software. Prepare provider applications including mailing or faxing enrollment applications as required.
- Submit notice of changes and follow up with the contractual insurance carriers and clients (account managers) regarding provider enrollment/termination/relocation status.
- Update appropriate provider enrollment stat matrix & daily project list. Send new provider requests to the medical billing service company. Generate provider reports upon request via the provider enrollment software. Work to assure appropriate charge capture and authorization is received.
- Collaborate with supervisor/manager and BMG management team to resolve account issues & billing issues as requested within revenue cycle and in appropriate information systems.
- Coordinate with the medical billing service company the hold and release of charges based on enrollment status with carrier, and perform follow up on held activity. Report any significant delays to management.
- Assist with completion of vendor EDI agreement forms required for electronic claims filing, and initial ERA agreement forms to receive electronic remittance with the Finance Department and the medical billing service company.
- Assist coding personnel with resolving provider enrollment denials. Coordinate with insurance carriers to maintain most current applications and processes for enrollment. Research enrollment requirements for new clients/carriers/provider types, and keep information current. Map enrollment applications.
- Analyze processes for areas of exposure to the organization, and recommend corrective action.
- Review all County & City Occupational Licenses; DE Medical Licenses; State Controlled Substance Certificates; Federal DEA Certificates to ensure up to date.
- Reporting: Monitor and report Physician Exception hold status and Hold/Release requests with Medical billing service company. Review FTE Provider Count Report on a monthly basis and provide information to the necessary parties.
- Cross train with various departments workflow as requested.
- All other duties as assigned, within the scope and range of job responsibilities.
- Education: High School Diploma or GED
- Credential: None Required
- Experience: At least three (3) years’ experience in an office setting requiring well-developed spreadsheet and word processing skills.
- Education: Associate Degree
- Credential: None Preferred
- Experience:
https://apply.bayhealth.org/join/ - 7 Days Ago
Credentialing Specialist
- MIG Consulting
-
Wilmington, DE
PART_TIME
- Job Summary:The Credentialing Specialist is responsible for screening and verifying the credentials, references, work experiences and other related items as well as maintaining all credentialing files...
- 2 Months Ago
Credentialing Specialist
- MIG Consulting
-
Wilmington, DE
PART_TIME
- Job Summary:The Credentialing Specialist is responsible for screening and verifying the credentials, references, work experiences and other related items as well as maintaining all credentialing files...
- 2 Months Ago
RN Staff Development/ IPC Nurse
- Medical Facilities of America
-
Wilmington, DE
FULL_TIME
- Ask about our Daily Pay And our 15K Sign on Bonus !!! Join our team at PIKE CREEK Nursing and Rehabilitation Center. As a member of our proud and caring team we care for our staff while we care for ou...
- 9 Days Ago
Supplemental Staff Registered Nurse (RN) - Surgical
- Peninsula Regional Medical Center
-
Seaford, DE
FULL_TIME
- Seaford, DETidalHealth NanticokeSurgical ServicesStandby(Work as needed) - Varied Weekdays, Rotating Weekends & Call - N/AReq #: 27496 Why work at TidalHealth?Looking for a rewarding place to work? Ch...
- 3 Days Ago
Staff Developer/Infections Control Registered Nurse
- Medical Facilities of America
-
Wilmington, DE
FULL_TIME
- Pike Creek Nursing and Rehab Center is seeking a Staff Developer/infections Control Registered Nurse. Planning and Organizing: You plan, organize, develop, implement, coordinate, and direct the infect...
- 7 Days Ago
Medical Staff Credentialing Supervisor jobs at Popular Companies
Credentialing Coordinator
- Advantage Tech
-
Aurora, CO
- Advantage Tech is hiring a Credentialing Coordinator for a client located in Aurora, Colorado. This position will be a 1...
- 6/11/2024 12:00:00 AM
Credentialing Coordinator
- National Anesthesia Services, Inc.
-
Franklin, MI
- Job Description Job Description Our company, National Anesthesia Services, Inc., is looking to hire a full-time Administ...
- 6/11/2024 12:00:00 AM
Credentialing Coordinator
- Insight Global
-
- Insight Global Health is searching for multiple Credentialing Specialists supporting the largest hospital system in Sout...
- 6/10/2024 12:00:00 AM
Credentialing Coordinator
- The LaSalle Group
-
Irving, TX
- LaSalle Network is excited to announce a partnership with a premier healthcare provider to recruit a talented Credential...
- 6/10/2024 12:00:00 AM
Credentialing Coordinator
- BayMark Health Services
-
Lewisville, TX
- Description Position at BayMark Health Services Credentialing Coordinator BayMark Health Services is looking for an orga...
- 6/10/2024 12:00:00 AM
Credentialing Coordinator
- Burnett Specialists
-
El Paso, TX
- Job Description Job Description Medical facility is looking for an experienced Payer Credentialing Coordinator. The Paye...
- 6/9/2024 12:00:00 AM
Credentialing Coordinator
- Belcan
-
New York, NY
- Onsite - NY - hybrid - 2 days in office, (preferably Tuesdays and Wednesdays, but negotiable at least one of those days)...
- 6/8/2024 12:00:00 AM
Credentialing Coordinator
- Apex Systems
-
Charlotte, NC
- Apex Systems is looking to hire a Customer Service Specialist for one of their reputable healthcare clients they support...
- 6/7/2024 12:00:00 AM
About Delaware
Delaware is 96 miles (154 km) long and ranges from 9 miles (14 km) to 35 miles (56 km) across, totaling 1,954 square miles (5,060 km2), making it the second-smallest state in the United States after Rhode Island. Delaware is bounded to the north by Pennsylvania; to the east by the Delaware River, Delaware Bay, New Jersey and the Atlantic Ocean; and to the west and south by Maryland. Small portions of Delaware are also situated on the eastern side of the Delaware River sharing land boundaries with New Jersey. The state of Delaware, together with the Eastern Shore counties of Maryland and two co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Supervisor jobs
$70,254 to $90,349
Most Popular Cities in Delaware for Medical Staff Credentialing Supervisor Jobs
What does a Medical Staff Credentialing Supervisor do?
Medical Staff Credentialing Supervisor in Indianapolis, IN
The Supervisor of Medical Staff Credentialing will provide direct supervision to medical staff office employees and promotes communication and collaboration between hospital administration and the organized medical staff.
December 21, 2019
Medical Staff Credentialing Supervisor in Montgomery, AL
The Supervisor of Medical Staff Credentialing will be responsible for daily operations of the medical staff office, including oversight of credentialing, privileging, bylaws and policy development, medical staff committee and peer review support, continuing medical education (CME), and compliance with The Joint Commission and other regulatory standards.
January 03, 2020