Emory Healthcare/Emory University • Atlanta, GA 30309
Job #2683917017
Overview
Prefered Qualifications: Proficiency with Verity, MSOW, and Qgenda a plus. Prior experience with Anesthesiology (CAA, CRNA, MD/DO) credentialing preferred.
Description
Manages credentialing functions for a large division or department (200+ providers).
Ensures compliance with policies, procedures and regulatory guidelines.
Supervises credentialing staff and coordinates all clinical privileging, reappointments/re-credentialing, provider licensing and billing enrollment.
Coaches staff to ensure high performance standards and timely onboarding of providers.
Participates in the development and administration of departmental policies and procedures.
Develops and executes the strategic direction of the credentialing and enrollment team to ensure provider friendly and efficient processes to ensure a consistent direction across the department.
Facilitates and oversees the major processes for credentialing of physicians and advance practice providers into Emory Healthcare Care (EHC), Emory Medical Care Foundation (EMCF), Emory Specialty Associates (ESA), and The Emory Clinic (TEC) and payor enrollment with Managed Care, Medicaid, and Medicare Enrollment working individual files as needed Develop collaborative relationships with key stakeholders, including - departmental physician, anesthetist, NP/PA, and administrative leadership, system credentialing and enrollment leadership, Grady offices of System Credentialing, and the Office of Managed Care.
Educates and advises staff on Credentialing and Enrollment policies and partners with the centralized credentialing team and hospital medical staff offices to streamline onboarding processes and ensure practices comply with organizational and legal requirements.
Ensures providers are licensed, privileged, and enrolled in billing by their start dates. Partners with HR to coordinate hiring dates with credentialing and enrollment timelines.
Teaches and leads continual process improvement and customer service processes.
Meets with new providers with the goal of seamlessly matriculating them into the Emory system.
Ensures direct reports correctly coordinate network and badge access for each location, billing orientations, department orientations, provide appropriate HR contacts, etc.
Partners with Finance, Patient Financial Services and Anesthesia Coding team to ensure proper billing provider set up in EPIC, billing effective dates for all payors are updated and all credentialing and enrollment edits are reviewed and resolved timely to achieve maximum reimbursement for services rendered. Other duties as assigned.
Bachelors degree in healthcare or business related field and at 5 least years of comprehensive credentialing and enrollment experience in an acute care hospital, managed care, or credentialing verification organization which includes two years of supervisory experience.
Must have previous experience working with physicians. Previous supervisory experience of at least one year.
Planning and organizational skills, with the ability to manage many different projects and people at once.
Ability to communicate tactfully, verbally and in writing with department heads, managers, coworkers, and vendors to resolve problems and negotiate resolutions.
Additional Details
Proficiency with Verity, MSOW, and Qgenda a plus. Prior experience with Anesthesiology (CAA, CRNA, MD/DO) credentialing preferred.
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Division The Emory Clinic
Campus Location Atlanta, GA, 30322
Campus Location US-GA-Atlanta
Department TEC Anesthesia Administration
Job Type Regular Full-Time
Job Number 127972
Job Category Revenue Cycle & Managed Care
Schedule 7a-5:30p
Standard Hours 40 Hours
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
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