Credentialing Account Manager
Current● Use advanced industry knowledge and individual judgment to determineaccuracy / compliance with laws, regulations, and standards (JC, NCQA, CMS,State) for med. staff / facility applications & audits.● Act as main PoC for client relations - liaising with all levels from Medical Staff,Office Managers & Directors, Auditors & Surveyors, Dept Chairs and Chiefs.● Responsible for all daily communications – in system, phone, email, reports,statuses, & escalations.● Leader for day-to-day provider maintenance making certain that applications(initial, reappointment, change in privilege, etc.) are prioritized and delegatedappropriately.● Implement electronic processing, retrieval, and verification of provider data incollaboration with other teams to manage expiring, audited, and in progressrecords.● Utilize statistical methods to explore, transform, and interpret large datasetsefficiently, while thriving in a high data load & faced paced environment..● Project experience with government & private insurance plans, health systems, &hospital networks - Medicare, Medicare advantage, and VA expert.
