Credentialing Analyst

Reviews the approval and termination of professional provider contracts.

Ensures accurate and timely information for re-credentialing, data analysis, and directory generation.

Recommends changes to credentialing criteria and processes.

Maintains all credentialing and re-credentialing policies and processes to ensure compliance with applicable regulations.

Develops and implements departmental goals and objectives with input from staff members.

Develops and implements departmental policies and procedures that guide and support the provision of services.

Interacts with all customers to ensure prompt and accurate communication to provide expected service and meet service goals.

Evaluates problems and develops and implements solutions.

Supports, encourages, and contributes to the professional growth of all department employees.

Responsible for the continuous assessment and improvement of the quality of care and services provided.

Adheres to all compliance and integrity program rules and requirements.

Manages all new client account setups, research, and development activities.

Manages VAS, provider enrollment, claims submission, and various other projects for the NASD department.

Trains and guides team members on new challenges in the healthcare industry while maintaining close coordination with providers (clients).

Implements and acts in accordance with MTBC's information security and privacy policies.

Ensures compliance with information security responsibilities specific to the job role.

Protects assets from unauthorized access, disclosure, modification, destruction, or interference.

Performs any other tasks assigned by the supervisor.

Skills:

MS Excel, Data Analytics, Billing Process Knowledge,#J-18808-Ljbffr