Piedmont
Overview
Oversees the management of the delegated credentialing process for all members of the Piedmont Clinic. Responsible for the timely and successful execution of payor audit requests. Serves as the subject matter expert (SME) on all delegated credential topics for Piedmont Clinic leaders. Partners with the Piedmont Healthcare Central Verification Office (CVO) and Piedmont Clinic Payer Enrollment Department to ensure all delegated credentialing requirements are met per NCQA guidelines and Piedmont Clinic delegated contracts. Qualifications
MINIMUM EDUCATION REQUIRED:
Bachelors degree required, or equivalent years of experience can be substituted (6 years). Minimum Experience Required Five (5) years of experience in credentialing health care providers, payor credentialing processes, and basic knowledge of a Central Verification Office are required. Additional Preferred Qualifications Certified Professional Medical Services Management (CPMSM); Certified Provider Credentialing Specialists (CPCS) Seniority level
Mid-Senior level Employment type
Full-time Job function
Human Resources Industries
Hospitals and Health Care
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Oversees the management of the delegated credentialing process for all members of the Piedmont Clinic. Responsible for the timely and successful execution of payor audit requests. Serves as the subject matter expert (SME) on all delegated credential topics for Piedmont Clinic leaders. Partners with the Piedmont Healthcare Central Verification Office (CVO) and Piedmont Clinic Payer Enrollment Department to ensure all delegated credentialing requirements are met per NCQA guidelines and Piedmont Clinic delegated contracts. Qualifications
MINIMUM EDUCATION REQUIRED:
Bachelors degree required, or equivalent years of experience can be substituted (6 years). Minimum Experience Required Five (5) years of experience in credentialing health care providers, payor credentialing processes, and basic knowledge of a Central Verification Office are required. Additional Preferred Qualifications Certified Professional Medical Services Management (CPMSM); Certified Provider Credentialing Specialists (CPCS) Seniority level
Mid-Senior level Employment type
Full-time Job function
Human Resources Industries
Hospitals and Health Care
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