Director of Credentialing

Exact Billing Solutions
US - Florida - Lauderdale Lakes
December 14, 2024

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

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

Benefits

Three weeks of paid time off in first year (more added with tenure)

Medical, dental, vision, long-term disability, and life insurance

Flexible Spending Account (FSA) and Health Savings Account (HSA) options

Generous 401(k) with employer match up to 6%

Exact Billing Solutions Culture

Integrity. Dependability. Attention to detail. All our team members exhibit these qualities when it comes to doing business. And when it comes to the business of supporting a team, as a company, we offer no less to our team members. We're a fast-paced, growing company delivering services that allow our clients to spend more time helping people. At the end of the day, it's people, not numbers, that drive our success.

Recruiter ID: #LI-TF1

Exact Billing Solutions participates in the U.S. Department of Homeland Security E-Verify program.
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Read the full job description and apply online on the recuiter's web-site

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