Manager of Credentialing - Full Time Days
Cape Fear Valley Health
Summary
Oversee, lead and coordinate the payer enrollment activities associated with employed and certain contracted providers, hospitals and group practices within Cape Fear Valley Health System.
Job description
Major Job Functions
- Work with Physician groups and Hospital departments on enrollment activities to ensure proper payment
- Works closely with Medical Group and Medical Staff Services to ensure all providers and new groups are onboarded from a payer enrollment perspective
- Work with CAQH and other organizations on the processing of credentialing applications
- Ensures NPI registry, PECOS, NPPES and NC Medicaid systems have consistent information related to CFV entities
- Ensure that enrollments, reenrollments and revalidations are handled timely, accurately and consistently
- Provides quality control measures to ensure that staff are properly trained and executing functions accurately and timely
- Other duties as assigned
Minimum Qualifications
Education and Formal Training: Associate’s degree required OR 4 years’ experience as a practice manager or administrator will be considered in lieu of degree. Bachelor’s degree preferred.
Work Experience: 2 years’ experience working with a large multi-specialty health system with knowledge and experience in credentialing and/or provider enrollment required.
Knowledge, Skills, and Abilities Required
- Proficiency in reading, writing, and speaking the English language
- Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations
- Strong written and verbal skills, be results oriented, and exemplify a team player attitude
- Expert skills in Microsoft Word, Excel, PowerPoint and Access
- Ability and willingness to work on a variety of activities and projects
- Ability to work with people in a tactful, diplomatic manner
Requirements
- Associate’s degree required OR 4 years’ experience as a practice manager or administrator will be considered in lieu of degree
- Bachelor’s degree preferred
- 2 years’ experience working with a large multi-specialty health system with knowledge and experience in credentialing and/or provider enrollment required
- Proficiency in reading, writing, and speaking the English language
- Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations
- Strong written and verbal skills, be results oriented, and exemplify a team player attitude
- Expert skills in Microsoft Word, Excel, PowerPoint and Access
- Ability and willingness to work on a variety of activities and projects
- Ability to work with people in a tactful, diplomatic manner
Company overview
Cape Fear Valley Health is a comprehensive regional healthcare system based in Fayetteville, North Carolina, serving southeastern North Carolina and surrounding regions. Established in 1956, it has grown to become North Carolina's 8th largest health system, operating as a private not-for-profit organization with 7,500 employees and over 1,000 physicians. The system encompasses eight hospitals with 988 total beds, including Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Bladen County Hospital, Hoke Hospital, and Harnett Health facilities. Annually, the system serves more than 1 million inpatient and outpatient visits across its network of over 150 locations. Cape Fear Valley Health specializes in cardiac care, cancer treatment, surgical services, neuroscience, pediatrics, rehabilitation, orthopedics, and behavioral health. The organization has earned numerous national recognitions including Healthgrades Top 100 Hospital for Cardiac Care, IBM Watson Top 50 Cardiovascular Hospital, and The Leapfrog Group Grade-A for Patient Safety. With a mission to provide exceptional healthcare for all patients, the system emphasizes patient-centered care, innovation, and community service while maintaining multiple disease-specific certifications from The Joint Commission.