Credentialing Team Lead

Description:

Meds Nexus is looking for candidates on the night shift with experience as Team Lead Credentialing & EDI. The candidate should be enthusiastic and must have a proven work experience in performing all New Client Account Setups, Research and Development activities, ensuring that the credentialing requirements for government and commercial payers are met, Submit and follow-up on submitted credentialing requests to all contracted commercial payers and government agencies, maintain the close working relations experience will be preferred along with Basic IT skills (databases, MS Office, etc.)

Job Responsibilities:

3 to 5 years of experience in credentialing department

At least 1 year of experience in a Supervisory Role

Experience in credentialing different specialties with major regular and private payers state-wise

Review the approval and termination of professional provider contracts as they relate to the credentialing process

Ensure accurate and timely information for re-credentialing, data analysis, and directory generation, as well as recommending changes to the credentialing criteria and processes

Maintain all credentialing and re-credentialing policies and processes to ensure that they comply with all applicable regulations

Develop and implement departmental goals and objectives with input from staff members

Develop and implement departmental policies and procedures that guide and support the provision of services