Provider Enrollment (Credentialing) Supervisor

Company: Disability Solutions
Location: Port Saint Lucie
Posted on: October 17, 2024

Job Description:

ABC Home Medical Supply, Inc is one of the nation's leading urological supply providers and serves as a one-stop shop with a comprehensive line of medical supplies and service that includes: Urological, Incontinence, Wound Care, and Ostomy. ABC Medical is part of the JDS, Inc family of businesses. Our service companies possess the knowledge and expertise to deliver first-class products and personalized home healthcare services.Location: Port Saint Lucie Department: Summary: The Provider Enrollment (Credentialing) Supervisor leads and supervises all aspects of licensing, credentialing, and application enrollment for ABC Medical, a Durable Medical Equipment (DME) company. The Supervisor ensures all applications, processed on behalf of multiple facilities, comply with Medicare, Medicaid, federal, state, and local licensing agencies as well as private health insurance companies. The Credentialing Supervisor leads a team of 3-4 direct reports. Responsibilities:

• Hire, lead, and develop a team of credentialing specialists to meet ABC objectives:
  • Ensure training, task organization, follow-up, and quality control for key activities.
  • Provide feedback, coaching, and direction to credentialing team.
  • Provide regular status updates of team initiatives.
  • Seek and provide proactive communication with the Compliance/Legal and other stakeholders
    • Speak up and communicate Credentialing expertise to ensure decisions are properly vetted.
    • Deliver clear, concise oral and written communications to a wide range of stakeholders.
    • Ensure timely and accurate payer applications, including but not limited to:
      • Filing initial enrollment applications
      • Updating applications, filing revalidations, and re-credentialing for Medicare, Medicaid, and commercial health insurance companies.
      • Ensure timely response to requests for information from federal, state, local agencies, and commercial insurance companies to meet the Company's licensing and credentialing obligations.
      • Ensure timely and accurate initial license applications, application updates, and renewal applications for city, county, state, local business, and DME/HME/Warehouse licensing agencies.
      • Maintain, manage, and distribute company Liability certifications, W9s and Accreditation certifications as requested and required to comply with all agreements.
      • Maintain and manage company Surety Bonds, Secretary of State filings, and various company specific documentation needed to complete applications.
      • Maintain meticulous filing of all applications and provider communications for the company.
      • Ensure proper review, distribution, and disposition of all incoming list serve emails, provider communications.
      • Provide clear, detailed communication on the status of applications, enrollments, and special project initiatives.
      • Other duties as assigned. Minumum Qualifications:
        • High School Diploma or GED
        • 2-5 years of relevant work experience
        • Demonstrated ability to provide direction and lead projects
        • Experience and deep knowledge of Provider Enrollment / Credentialing - preferably in a DME setting with multiple locations and Payers
        • Durable Medical Equipment (DME) provider enrollment experience
        • Medicare enrollment experience (PECOS)
        • 5+ years of facility enrollment experience or relevant credentialing experience
        • Advanced Microsoft Office skills
        • Experience maintaining Liability Insurance and or Surety Bonds
        • Ability to troubleshoot complex payor events Preferred Qualifications:
          • Associates or Bachelor's Degree Job Req ID: 33584 EOE Statement:All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.Accommodations Statement:ABC Medical endeavors to make www.abc-med.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the ABC Medical HR Department at HR@abc-med.com . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Keywords: Disability Solutions, Jupiter , Provider Enrollment (Credentialing) Supervisor, Other , Port Saint Lucie, Florida