Senior Credentialing Team Lead

Jobright is an AI-powered career platform that helps job seekers discover the top opportunities in the US. We are NOT a staffing agency. Jobright does not hire directly for these positions. We connect you with verified openings from employers you can trust.

Job Summary:

HealthDrive Corporation is a mobile healthcare company that provides essential healthcare services to elderly residents in extended care facilities across multiple states. The Credentialing Team Lead will ensure that all provider types are credentialed and re-credentialed in a timely manner, while also handling project work in Regulatory Affairs and minor administrative duties.

Responsibilities:

• Maintains high-quality, up-to-date, and accurate credentialing processes for all provider types.

• Monitors collection of information and documents received ensuring all items required for credentialing are received during the onboarding process.

• Advises Supervisor of any questionable information received, and any issues identified during the processes.

• Monitors the insurance payer requests in the internal Credentialing application as well as in the company’s third-party credentialing vendor’s portal.

• Works with and assists company’s third-party credentialing vendor and internal Credentialing Coordinators for accurate and timely completion of payer applications, collection of provider signatures, and tracking of payer credentialing until approvals are received.

• Holds company’s third-party credentialing vendor to contracted SLAs.

• Reviews provider expiring document reports and payer revalidation due date reports to ensure that all required documents have been renewed and payer revalidations submitted.

• Other duties and responsibilities as assigned.

Qualifications:

Required:

• Outstanding organizational skills and attention to detail.

• Excellent judgment & prioritization skills proactively prioritize needs and effectively manages resources.

• Must have excellent communication skills: verbal, interpersonal and written. This includes strong spelling and grammar skills and basic mathematical calculations.

• Must have strong ability to self-direct and work both independently and with a team in a high-volume, deadline-driven role.

• Prior insurance payer credentialing experience required.

• Customer orientation: establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

• Policies & procedures: articulates knowledge and understanding of organizational policies, procedures, and systems.

• PC Skills: demonstrates proficiency in Microsoft Office (Excel, Access, Word) applications and other as required.

• Ability to maintain confidentiality of privileged information gained.

Company:

HealthDrive Corporation is a hospital & health care company specializing in on-site dentistry and audiology services. Founded in 1989, the company is headquartered in Wellesley, Massachusetts, USA, with a team of 501-1000 employees. The company is currently Late Stage.