Analyst, Physician Credentialing Position Available In Davidson, Tennessee

Analyst, Physician Credentialing ArchWell Health – 2.7

Nashville, TN Job Details Full-time Estimated:

$48K – $62.2K a year 1 day ago Qualifications Medicare Mid-level 3 years Bachelor’s degree Organizational skills Care plans Medical terminology Communication skills Full Job Description ArchWellHealth is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities. Job 

Summary:

The provider credentialing analyst is responsible for credentialing new providers and maintainingcurrent provider files for our quickly growing medical group.

This hire will partner with current credentialing staff and own the end-to-end credentialing process, including: submitting and tracking credentialing applications to various contracted managed care plans and government payorsfor oncoming providers; maintainingthe data for all providers within the group;trackingthe expiration of certification and licenses;and will act as a liaison betweenpayors, external credentialing service firms,and medical staff, including physicians. Duties/Responsibilities Build the ArchWell Health credentialing workplan and processes, including all required credentialing for physicians and facilities as dictated by government payors and contracted managed care plans Conduct all necessary credentialing for physicians and facilities, including: Conducting background checks Contacting licensing boards Reviewing license applications Obtaining education information Completing references Ensuring the facility is operating within state and federal regulations Own all payor reporting, including data reporting and monthly exclusion checks Oversee ongoing renewals for all required physician licensesand credentials Act as a liaison between government payors and managed care plans, outsourced credentialing services, and ArchWell Health medical staff, including providers

Required Skills/Abilities:

Must understand Medicare, Medicaid, and managedcare plancredentialing requirements, and must be familiar with CAQH (Council for Affordable Quality Healthcare) Must also be able to work/communicate with providers in a professional manner to assist in the completion of the CAQH applications Knowledge of medical terminology, strong organization skills, good written communication skills, ability to work independently, and ability to conduct research while performing job duties The position also requires a person who is able to communicate well with all levels of staff, physicians, and patient referral sources

Education and Experience:

Bachelor’s degree preferred At least three (3) years of medical credentialing and enrollment experience Proficient PC skills Embodies and serves as a role model of

ArchWell Health’s Values:

Be compassionate Strive for excellence Earn trust Show respect Stay resilient Always do the right thing ArchWellHealth is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.