ICBD Holdings LLC
Director of Credentialing
ICBD Holdings LLC, Lauderdale Lakes, Florida, United States
Description
Director of Credentialing - Exact Billing Solutions
Lauderdale Lakes, FL
About Exact Billing Solutions
Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental health, and autism fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.
Leadership Opportunity
If you're an experienced healthcare credentialing professional looking for a unique opportunity with a rapidly growing company, this could be a turning point in your career. Our Director of Credentialing plays a crucial role in ensuring that healthcare professionals within an organization meet all necessary qualifications, certifications, and regulatory requirements. The Director of Credentialing will be responsible for credentialing analysis, quality assurance, planning, client/vendor relationships, and continuous improvement of operational performance throughout our nationwide healthcare units.
What You'll Do Analyze and implement process improvements to enhance efficiency of credentialing Conduct ongoing program evaluations and audits of data integrity Ensure accurate outcomes and compliant procedures to meet service goals Coordinate with practice management, licensing agencies, insurance carriers, and other organizations to complete credentialing applications Manage staff, including hiring qualified candidates, career development, training, monitoring productivity and accuracy, and conducting performance evaluations Serve as primary resource to employees with regard to issues, interpretation, and application of policies and procedures Resolve the most complex problems related to credentialing Work with various departments to ensure a smooth transition of providers when onboarding, for new contracts, and during acquisitions Assume responsibility for personal continuing education and development needs; attend meetings and workshops to enrich personal knowledge, growth, and management skills Foster good relationships with clients Requirements
Education/Experience and Other Requirements
Bachelor's degree (MBA preferred) 10+ years of combined management, credentialing, or regulatory affairs experience, preferably in a managed care or insurance environment Ability to work with physicians in a collaborative manner Certified Provider Credentialing Specialist (CPCS) and Certified Professional in Medical Staff Service Management (CPMSM) (preferred) Experience with and knowledge of CAQH and credentialing processes Knowledge of delegated credentialing and verification Knowledge of related accreditation and certification requirements Ability to create, implement, document, and audit policies and procedures Manage direct and indirect remote employees Must maintain clean background/drug screenings and driving record Expertise Needed
Ability to effectively prioritize and execute tasks in a high-pressure environment Ability to lead and manage others, strong interpersonal, project management and mentoring skills Strong collaboration skills for working with other departments, such as Human Resources, Legal, Admissions, and Compliance
Director of Credentialing - Exact Billing Solutions
Lauderdale Lakes, FL
About Exact Billing Solutions
Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental health, and autism fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.
Leadership Opportunity
If you're an experienced healthcare credentialing professional looking for a unique opportunity with a rapidly growing company, this could be a turning point in your career. Our Director of Credentialing plays a crucial role in ensuring that healthcare professionals within an organization meet all necessary qualifications, certifications, and regulatory requirements. The Director of Credentialing will be responsible for credentialing analysis, quality assurance, planning, client/vendor relationships, and continuous improvement of operational performance throughout our nationwide healthcare units.
What You'll Do Analyze and implement process improvements to enhance efficiency of credentialing Conduct ongoing program evaluations and audits of data integrity Ensure accurate outcomes and compliant procedures to meet service goals Coordinate with practice management, licensing agencies, insurance carriers, and other organizations to complete credentialing applications Manage staff, including hiring qualified candidates, career development, training, monitoring productivity and accuracy, and conducting performance evaluations Serve as primary resource to employees with regard to issues, interpretation, and application of policies and procedures Resolve the most complex problems related to credentialing Work with various departments to ensure a smooth transition of providers when onboarding, for new contracts, and during acquisitions Assume responsibility for personal continuing education and development needs; attend meetings and workshops to enrich personal knowledge, growth, and management skills Foster good relationships with clients Requirements
Education/Experience and Other Requirements
Bachelor's degree (MBA preferred) 10+ years of combined management, credentialing, or regulatory affairs experience, preferably in a managed care or insurance environment Ability to work with physicians in a collaborative manner Certified Provider Credentialing Specialist (CPCS) and Certified Professional in Medical Staff Service Management (CPMSM) (preferred) Experience with and knowledge of CAQH and credentialing processes Knowledge of delegated credentialing and verification Knowledge of related accreditation and certification requirements Ability to create, implement, document, and audit policies and procedures Manage direct and indirect remote employees Must maintain clean background/drug screenings and driving record Expertise Needed
Ability to effectively prioritize and execute tasks in a high-pressure environment Ability to lead and manage others, strong interpersonal, project management and mentoring skills Strong collaboration skills for working with other departments, such as Human Resources, Legal, Admissions, and Compliance