Credentialing Team Lead at Summit Brands

Walnut Creek, California, United States -

Full Time

Start Date

Immediate

Expiry Date

24 Dec, 25

Salary

70174.0

Posted On

25 Sep, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Judgement, Decision Making, Insurance Management, Medicare Enrollment, DME Revalidations, Problem Solving, Compliance Evaluation, Coaching, Integrity, Adaptability, Attention to Detail, Technical Skills, Teamwork, Positive Attitude

Industry

Description

Description Credentialing Team leads, oversee and manage the entire credentialing process for healthcare providers, ensuring compliance with regulations and accreditation standards, while also leading and supporting the credentialing team. Developing and maintaining policies and procedures and ensuring accurate and timely completion of credentialing activities. Responsibilities • Monitors, on an ongoing basis, all expirables, such as medical licenses, DEA certificates, Furnishing license, Fluoroscopy certificate, board certification and malpractice insurance, BLS, etc. • Answers escalated departmental emails and main phone line calls. • Develop and maintain a qualified medical staff by overseeing the credentialing process for all new providers and reappointments. • Monitor the medical staff status to ensure compliance with federal and state regulations. • Maintain a comprehensive database of medical staff information. • Monitor all privileging credential documents to ensure accuracy. • Facilitate communication between the medical staff and other departments. • Consult with external organizations to ensure compliance with credentialing requirements. • Ensure all stakeholders are informed of credential updates and changes. • Participate in the development and implementation of quality improvement programs. • Perform other duties as assigned. Requirements • Excellent customer service written and verbal skills. • Judgement and decision making • 5+ years in managing various insurance types: HMO, FQHC, PPO and IPA. • Medicare PECOS/Medi-Cal PAVE Enrollment • Durable Medical Equipment (DME) Revalidations/Reassignments/Enrollment • Complex problem solving • Evaluating information to determine compliance with standards • Coaching and developing others. • Integrity • Adaptability/Flexibility • High attention to detail. • Proficient Technical skills Credential Stream, Cactus, Credential My Doc (CMD) (including Microsoft Excel, Outlook, Zoom, Teams, Word, Adobe PDF, & Internet) • Works well as a team and independently. • Positive “can do” attitude. Education: Some college no degree required or 5- 10 years of work experience. Reports To: Senior Credentialing Manager Work Schedule: Monday-Friday 8:30am-5:00pm. Salary Range: $56,128-$70,174 Start date: ASAP

Responsibilities

The Credentialing Team Lead oversees and manages the entire credentialing process for healthcare providers, ensuring compliance with regulations and accreditation standards. They also lead and support the credentialing team while developing and maintaining policies and procedures.