Credentialing Manager

Credentialing Manager

National Spine & Pain Centers, one of the nation's largest interventional pain management practice, is seeking a Credentialing Managerto support our Compliance team!

The Credentialing Manager is responsible for overseeing all aspects of the credentialing, re-credentialing, and privileging processes for all medical providers who provide patient care at National Spine & Pain Centers (NSPC). This position directly supervises all credentialing specialist staff, and carries out required managerial responsibilities in accordance with all NSPC policies and applicable laws.

National Spine & Pain Centers offers supportive management, a great working environment, competitive compensation, medical/dental/vision insurance options, life insurance plans, employer matched 401(k), holidays and PTO.

We encourage all prospective candidates to learn more about National Spine & Pain Centers by viewing our website at http://www.treatingpain.com.

Successful candidates MUST possess the following:

• Associates Degree or four (4) year Bachelor’s Degree preferred.
• Certified Provider Credentialing Specialist preferred.
• At least three (3) years of supervisory or management level experience in managed care, medical staff services, health services or healthcare credentialing programs; or an equivalent combination of education and experience which would provide the required knowledge, skills, and abilities.
• At least five (5) years of experience in healthcare credentialing, medical billing follow-up, patient registration, charge entry, billing, and medical policies.
• Advanced knowledge of PECOS and CAQH.
• Advanced knowledge of applicable credentialing and licensing requirements for physicians, mid-levels and the Ambulatory Surgical Centers (ASC).
• Advanced knowledge of applicable state board of licensing applications for medical providers.
• Advanced knowledge of Medicare credentialing procedures and protocols for medical providers and ASC.
• Advanced knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, Manage Care, and Commercial insurance carriers billing regulations.
• Ability to review and interpret patient bills, vouchers, error lists and reports to identify incorrect data and make appropriate revisions.
• Proficient with Microsoft Office Suite and the aptitude to learn new software technology, as required.
• Must be authorized to work in the United States and not require work authorization sponsorship by our company for this position now or in the future.
• Must have satisfactory background check inclusive of driving, criminal, employment reference, education, and social security.