Credentialing Account Manager

🕒 Julho 17

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Assembly Health

SiteLinkedInTodas as Vagas

201 - 500 funcionários

💼 Consultoria

📦 Logística

🏥 Saúde

Consulting • Logistics • Healthcare

A Assembly Health é dedicada a elevar o desempenho financeiro de provedores de saúde por meio de soluções inovadoras de gestão do ciclo de receita e suporte administrativo. Sua equipe especializada e tecnologia otimizam processos, permitindo que as organizações de saúde se concentrem em oferecer um atendimento de qualidade aos pacientes. Com uma abordagem abrangente que inclui análises, consultoria de conformidade e serviços de pessoal, a Assembly Health atende uma ampla gama de especialidades médicas e comunidades de cuidados prolongados nos Estados Unidos.

Descrição

• Serve as main point of contact for assigned clients, addressing inquiries and concerns proactively. • Conduct regular client meetings to review provider enrollment and credentialing data, discuss challenges, and align on goals. • Monitor and analyze key performance indicators (KPIs) such as retention/turnover rate, credentialing turnaround time, Network Adequacy, Net Promoter Score, etc. • Oversee all provider enrollment, credentialing, and re-credentialing activities to ensure accuracy, timeliness, and payer compliance. • Ensure effective tracking, reporting, and documentation of enrollment status, payer communications, and provider data across systems. • Act as the primary point of contact for complex provider, payer, or claims-related issues. • Identify and implement process improvements to streamline workflows, reduce cycle times, and improve provider experience. • Standardize SOPs, reporting structures, and quality controls across the Provider Relations function. • Analyze trends, bottlenecks, and performance metrics to inform decision-making and continuous improvement initiatives. • Serve as a key liaison with internal teams including Revenue Cycle, Operations, Compliance, and Clinical Leadership. • Provide executive-level updates and reporting to leadership on provider enrollment status, risks, and capacity planning. • Ensure clear, professional communication with providers and external partners.

🎯 Requisitos

• 5+ years of experience in provider relations, credentialing, enrollment, or healthcare operations. • 2+ years of people management experience, including managing Team Leads or supervisors. • 2+ years of account management or customer success experience, serving as primary point of contact for clients. • Strong understanding of medical billing, payer enrollment, claims resolution, and healthcare workflows. • Proven ability to lead teams, drive accountability, and implement scalable processes. • Bachelor’s degree required; degree in healthcare administration, business, or process improvement preferred. • Exceptional organizational, analytical, and reporting skills. • Strong communication skills with the ability to influence across levels and functions. • Proficiency in Microsoft Office Suite and credentialing/enrollment databases. • Ability to thrive in a fast-paced, high-growth environment with evolving priorities. • Detail-oriented with strong problem-solving and decision-making capabilities.

🏖️ Benefícios

• Health insurance • Dental insurance • Vision insurance • 401(k) • Paid time off • Bonus programs