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Pinnacle Wound Management

Revenue Cycle Manager

Pinnacle Wound Management, Gainesville, Georgia, United States, 30501

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Be among the first 25 applicants Pinnacle Wound Management is a leading wound care provider dedicated to delivering high-quality patient care. We are seeking a detail-oriented

Revenue Cycle Manager

to join our team. This role is critical in ensuring our healthcare professionals meet all necessary licensing, certification, and regulatory requirements. As a

Revenue Cycle Manager , you will be responsible for managing the credentialing and re-credentialing process for all of our physicians and mid-level healthcare providers. You will maintain accurate records, verify professional credentials, and ensure compliance with industry regulations and accreditation standards. If you are a meticulous and organized professional with a passion for healthcare compliance, we want to hear from you! Apply now to join us in ensuring the highest standards of wound care excellence!

Responsibilities

Maintain accurate and up-to-date provider files, ensuring compliance with all credentialing requirements

Complete and track initial and re-credentialing applications for various health insurance portals, including CAQH, PECOS, NPPES, Navinet, Availity, PaySpan, CMS, and Managed Care Organizations

Assist new providers with applications for National Provider Identifier (NPI), Medicare, and Medicaid numbers; monitor and update provider CAQH profiles in accordance with CMS and Managed Care Organization guidelines

Manage termination of payer enrollments for providers leaving the organization

Provide updated demographic information and supporting documents to external stakeholders, including commercial payers and billing entities

Collaborate with the Director of Operations to ensure timely credentialing and re-credentialing of all providers

Track and ensure the renewal of state DEA licenses, board certifications, and malpractice insurance

Identify and resolve potential onboarding issues, offering solutions to streamline the credentialing process

Maintain records of all managed care contracts and ensure portal logins remain active; ensure compliance with relevant accrediting and regulatory agencies

Monitor trends and recommend improvements to credentialing workflows

Qualifications

High school diploma or equivalent; credentialing certificate preferred

Minimum of 5 years experience in physician credentialing, revenue cycle management, or related field

Knowledge of credentialing standards and healthcare regulations

Proficiency in credentialing software and Microsoft Office Suite

Strong attention to detail, organizational, and problem-solving skills

Excellent written and verbal communication skills

Ability to work independently and manage multiple tasks efficiently

Benefits

401k

401k matching

Competitive pay

Medical, dental, and vision insurance

Paid time off

Free parking

No nights, no weekends

Monday - Friday, 8 hour shift

Seniority level

Entry level

Employment type

Full-time

Job function

Health Care Provider

Industries

Hospitals and Health Care

Note: This description focuses on the Revenue Cycle Manager role and its requirements. Other job postings and non-essential notices have been removed to provide a clear, focused listing.

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