Credentialing Provider Enrollment Manager Jobs in Rochester, NY

Riedman Campus

Full time

REQ_237552

JOB TITLE: Provider Enrollment Associate-Lead - Riedman Campus, Admin/Business Support (Full-Time, Days)

STATUS: Full-time

LOCATION: Riedman Campus - 100 Kings Highway South, Rochester, NY 14617

SCHEDULE: M-F, 8:00 AM - 4:30 PM; can be flexible to start earlier

SUMMARY:

In addition to performing in the role of a Provider Enrollment Associate, provides leadership and assists the Director in facilitating the workflow, for a team of Provider Enrollment Associates. Provides knowledge, expertise and guidance to the team, thus ensuring credentialing is completed in an organized and timely fashion. Credentialing includes but is not limited to all carrier forms and online credentialing application processes and maintenance and training of Provider Enrollment Associates for Apogee software. Position requires thorough application review and filing with appropriate follow-up to ensure prompt payment by payors.

RESPONSIBILITIES:

• Plans, organizes, assigns, and supervises the day-to-day operations and workflow of the Provider Credentialing team.

• Provides leadership, guidance, and subject matter expertise to Provider Credentialing Associates, ensuring work is completed accurately, timely, and in accordance with regulatory standards.

• Orients, trains, coaches, and evaluates team members to support a competent and productive workforce.

• Monitors team workload and staffing coverage to ensure operational demands, priorities, and deadlines are met.

• Partners with the Manager/Director regarding team performance, recognition, coaching, and performance management.

• Develops and implements electronic processes and workflow improvements to increase efficiency, accuracy, and productivity.

• Reviews and validates provider qualifications and ensures completion of credentialing and enrollment applications.

• Prepares, reviews, and submits provider applications and supporting documentation to contracted insurance payors in a timely manner while maintaining confidentiality.

• Ensures the accuracy and integrity of provider data and credentialing records, including monitoring the Apogee credentialing software.

• Serves as a key liaison with administration, practice managers, provider recruitment, hospital credentialing, and external vendors to facilitate provider enrollment and credentialing activities.

MINIMUM QUALIFICATIONS:

• Basic computer skills required.

• Excellent customer service and communication skills required.

• Minimum Qualifications:

• Associate's degree or an equivalent combination of education and work experience.

• 4 years related work experience in a healthcare setting preferred.

• NYS Notary Public required 1 year from date of hire (Per Diem employees excluded).

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$19.75 - $23.00

CITY:

Rochester

POSTAL CODE:

14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials. It’s vision is to lead the evolution of healthcare to enable every member of the communities it serves to enjoy a better, healthier life.