Director of Credentialing and Provider Enrollment
Full Time
Phoenix, AZ 85016
Posted
Job description
Company Intro:
At
American Vision Partners (AVP), we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas – including 25 ambulatory surgical centers.
At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees!
Overview:
At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees!
The Director of Credentialing is responsible for the oversight and execution of all provider payor enrollments, facility licensing, provider licensing, and credentialing activities across multiple states and entities. Provides supervision and day to day oversight of credentialing and provider enrollment teams.
Responsibilities:
1. Manages, keeps up-to-date, tracks expirations and processes payments of all provider
licenses, membership dues and registrations.
2. Responsible for provider privileging, initial and re-credentialing process for Medical Staff,
and Allied Healthcare Professionals at hospitals.
3. Responsible for managing onboarding of provider new hires ensuring that credentialing and
provider health plan enrollment is completed in an efficient manner in order to maximize
revenue opportunities.
4. Assists with state and other agency surveys including CMS and AAAHC surveys.
5. Manages, keeps up-to-date, tracks expirations and processes payments of all facility state
licenses dues and registrations.
6. Manages, keeps up-to-date, tracks expirations and processes payments of laser equipment
dues and registrations.
7. Manages, keeps up-to-date, tracks expirations and processes payments of premium
services expenses (e.g., provider and location dispensing licenses & registrations).
8. Ensures that all DME locations are licensed and enrolled with appropriate payors.
9. Responsible for ensuring that all delegated credentialing requirements are met and
maintained.
10. Ensures compliance with applicable laws and regulations of AAAHC, state and federal
government agencies.
11. Maintains an accurate credentialing database.
12. Maintains accurate document filing in appropriate provider and facility folders.
13. Performs primary source verification of all components of the providers and facilities.
14. Identifies issues that require additional investigation and evaluation, validates discrepancies
and ensures appropriate follow up.
15. Performs other duties as assigned.
Qualifications:
licenses, membership dues and registrations.
2. Responsible for provider privileging, initial and re-credentialing process for Medical Staff,
and Allied Healthcare Professionals at hospitals.
3. Responsible for managing onboarding of provider new hires ensuring that credentialing and
provider health plan enrollment is completed in an efficient manner in order to maximize
revenue opportunities.
4. Assists with state and other agency surveys including CMS and AAAHC surveys.
5. Manages, keeps up-to-date, tracks expirations and processes payments of all facility state
licenses dues and registrations.
6. Manages, keeps up-to-date, tracks expirations and processes payments of laser equipment
dues and registrations.
7. Manages, keeps up-to-date, tracks expirations and processes payments of premium
services expenses (e.g., provider and location dispensing licenses & registrations).
8. Ensures that all DME locations are licensed and enrolled with appropriate payors.
9. Responsible for ensuring that all delegated credentialing requirements are met and
maintained.
10. Ensures compliance with applicable laws and regulations of AAAHC, state and federal
government agencies.
11. Maintains an accurate credentialing database.
12. Maintains accurate document filing in appropriate provider and facility folders.
13. Performs primary source verification of all components of the providers and facilities.
14. Identifies issues that require additional investigation and evaluation, validates discrepancies
and ensures appropriate follow up.
15. Performs other duties as assigned.
Education
Prior Experience:
Preferred Experience:
Skills and Proficiencies:
Physical Abilities:
Benefits & Perks:
- Bachelor's degree in Business Administration, Health Care Administration, Public Health
Prior Experience:
- Minimum 5 years’ leadership experience directly related to healthcare medical staff
- Demonstrated prior ASC credentialing experience with Medicare Deemed Status
- Demonstrated experience managing credentialing or provider enrollment teams.
- Strong communication and interpersonal skills necessary to interact effectively with
Preferred Experience:
- Current Certified Provider Credentialing Specialist (CPCS) with the National Association of
- Experience in a multi-site healthcare facility including handling credentialing requirements
Skills and Proficiencies:
- Excellent verbal, written and presentation skills.
- Excellent Computer Skills (Word, Excel, Adobe & Microsoft Outlook)
- Extremely organized and detail oriented with exceptional follow through skills.
- Ability to multi-task in a fast pace environment; can adapt quickly to change; and have
- Ability to organize workload, manage multiple projects, and maintain confidentiality of all
- Ability to establish and maintain effective working relationship with team members, clinic
Physical Abilities:
- Ability to sit for long periods. Work requires walking, bending, standing, sitting, and
Your health, happiness and your future matters! At AVP, we offer everything medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
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