The Payer Enrollment Team Lead is an important member of The Payer Enrollment Team. This individual will assist upper management daily by providing support and guidance to the team of Credentialing Specialists on daily tasks, processes, and workflow management. The Team Lead will serve as a resource for staff by providing ongoing training, mentoring, coaching, and knowledge sharing to support employee development, performance improvement, and adherence to credentialing standards and best practices.

In addition, this individual will maintain an individual workload and be responsible for preparing correspondence, gathering credentialing documentation, and working with the credentialing vendor to submit applications to insurance organizations for both initial credentialing and recredentialing. The Credentialing Specialist Team Lead will also assist with onboarding new team members, facilitating training initiatives, and helping to establish consistent processes and procedures across the department.

The Payer Enrollment Team Lead will coordinate with physicians, practice managers, practice directors, and executive-level leaders. Ultimately, these functions serve to ensure there are no lapses in credentialing and to promote collaboration with our credentialing vendor and Contracting teams to maintain insurance participation and coverage for our providers, patients, and the communities we serve.

Essential Functions:

• Maintain Individual Payer Enrollment Workload 
• Day to day guidance, training and support to credentialing specialists
• New Hire Training /Onboarding and Mentoring 
• Helping staff members learn new skills and solve daily problems; hands on project support throughout team
• Works with other department managers and staff, including physicians, managed care, contracting, and other professional staff, to acquire necessary materials and information for provider certification and licensure to promote organization-wide compliance with credentialing policies and procedures
• Helps Implement process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies by leading by example
• Assists with auditing provider credentialing and enrollment files to ensure accuracy, completeness, compliance with organizational policies, payer requirements, and regulatory standards
• Key liaison with Medical Staff team, outside vendors
• Assists in completing and reviewing applications with practitioners and other applicable staff
• Performs periodic quality assurance reviews and audits of credentialing, enrollment, and provider data files to identify discrepancies, monitor compliance, and support continuous process improvement efforts
• Assist with additional duties, special projects and departmental initiatives as assigned by leadership to support organizational goals, operational efficiency, and continuous process improvement

Minimum/Preferred Qualifications:

Education:

• HS – High School Diploma or GED is required
• AA – Associate of Arts is preferred

Work Experience

At least two years of experience in physician credentialing is required  

Knowledge, Skills and Abilities:

• Exemplary problem-solving and conflict-resolution skills
• Detail-oriented
• Skilled in synthesizing a wealth of information
• Exhibits excellent time management and prioritization abilities
• Communicates effectively both one-on-one and in a group setting
• Capable of following and providing detailed instructions both orally and through written communication
• Experience with credentialing database management software preferred
• Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project) 

This job will be fully remote.

Our Billing Co. offers a competitive benefits package!

Pay Range: $30.00 - $32.00

Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations.

JOB CODE: 1000129