Credentialing and Payer Enrollment Manager
Affect Therapeutics
Remote
Posted on Sep 21, 2024
At Affect Therapeutics, we are a mission-driven company where your work directly and immediately impacts the well-being of others. You will make a tangible difference in people's lives from day one. By providing medical and behavioral services through our digital recovery program, we unlock our members’ potential to not only rebuild their lives but also create a ripple effect of positive change in the lives of their families, friends, and society at large.
Join our incredible team at Affect as we expand our credentialing and revenue operations group. We are seeking an experienced Credentialing and Payer Enrollment Manager to oversee the credentialing process for healthcare providers and manage payer enrollment for all relevant payers, including commercial insurance, Medicare, and Medicaid. This role ensures that all providers maintain active credentials and payer enrollments, minimizing any disruptions to service delivery or reimbursement.
Key Responsibilities:
- Manage the credentialing process for all healthcare providers, ensuring timely completion and ongoing compliance with payer requirements.
- Oversee payer enrollment activities for new and existing providers, ensuring that all providers are credentialed and enrolled in a timely manner.
- Monitor credentialing and payer enrollment timelines and proactively address delays or issues.
- Maintain up-to-date records of provider credentials and payer contracts in compliance with regulatory and payer standards.
- Collaborate with the RCM and finance teams to resolve any credentialing or enrollment issues that may impact reimbursement.
- Develop and maintain relationships with payers to ensure efficient payer enrollment and re-credentialing processes.
- Ensure compliance with state, federal, and payer-specific requirements for credentialing and enrollment.
- Provide regular reports on the status of provider credentialing and payer enrollments to leadership.
Qualifications:
- Bachelor’s degree in healthcare administration, business, or a related field.
- Minimum of 5 years of experience in healthcare credentialing and payer enrollment.
- Familiarity with substance use disorder treatment services is highly preferred.
- Strong knowledge of payer requirements, including Medicare, Medicaid, and commercial insurance.
- Excellent organizational and time management skills.
- Strong communication and relationship management skills.
- Proficiency with credentialing and payer enrollment software and systems.
We are unable to sponsor H1-B Visas at this time. Please do not apply if you are not within US time zones.
If you are passionate about making a difference in the lives of individuals with substance use disorders, possess the qualifications outlined above, and want to be part of a forward-thinking organization that values passion, empathy, and accountability, we encourage you to apply for the Credentialing and Payer Enrollment Manager position at Affect Therapeutics.
Join our team and contribute to our mission to transform the lives of individuals affected by substance use disorders through innovative treatment approaches, cutting-edge research, and compassionate care.
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