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Description
This position is incentive eligible.
Introduction
Directors thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We are looking for a Director of Clinician Credentialing for our Hospital Based Services (HBS) team where excellence creates excellence.
Benefits
HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
HCA Healthcare has expanded our influence across the healthcare industry by investing 3.5 billion in capital improvements in recent years. Do you want to be an influencer in healthcare? Apply for our Director of Clinician Credentialing role today!
Job Summary and Qualifications
GENERAL SUMMARY OF DUTIES:
Directs all operational components of the Hospital Based Services (HBS) Credentialing process. Directs activities related to payer enrollment as assigned to team. Serves as the central point of contact for credentialing and payer enrollment operations in HBS for our MSO’s and Parallon business partners. Directs and coordinates all credentialing activities and payer enrollment activities. Responsible for strategy, implementing best practices and innovating operations around credentialing and enrollment of clinicians. Leads team of credentialing specialists and ensures clinicians are credentialed, enrolled and all renewals and expirations are managed and kept up to date for HBS clinicians.
The objective of this position is to streamline operations and improve revenue cycle metrics through detailed analysis and process improvement, working together with Provider Enrollment, Coding Education, Payor Contracting and Analytics, Transition Management,
Accounts Receivable Management, as well as with the Parallon and Division, Market and Practice leadership. This position focuses on providing a centralized resource to improve our revenue growth, cash payments, and optimization, and guide practice operators towards higher levels of performance.
SUPERVISOR: HBS COO
DUTIES INCLUDE BUT NOT LIMITED TO:
• Oversee the revenue cycle efforts in the practices within the division, partnering with Parallon and other HCA PSG departments.
• Serve as primary contact for the CPC and the hospital Medical Staff offices for credentialing and re-credentialing all providers.
• Ensure the timely completion of deliverables in conjunction with the enrollment process is met, including facilitating across departments throughout the life cycle of onboarding.
• Manage all Division/Market-related Credentialing activities
• Plan and conduct training of a Credentialing/Enrollment Department in any Market/Division hospital acquisitions as needed.
• Collaborate with Parallons Division Account Manager and practice leadership to improve Division A/R Days (charge Lag, claims on hold, insurance denial issues, and training).
• In conjunction with new colleague orientation, manage the front desk and IET resolution training for practice Medical Office Specialists and Medical Office Coordinators.
• Implement processes to decrease denials by focusing on top denial reasons and working with practice leadership, account management, and coding.
• Implement processes to decrease final denials by focusing on the top ten denial reasons.
• Coordinate with other entities, including Parallon, Division, and Market Leadership, and established vendors to exchange information and coordinate efforts.
• Manage the implementation and training of PK, DFT interfaces.
• Primary contact with Parallon Business Performance Group (Provider Enrollment, Account Management, HCI, Coding, Compliance, CBO).
• Be proactive in identifying ways to improve the credentialing process, payer enrollment and revenue cycle.
EDUCATION:
• Bachelors degree or equivalent combination of education and/or work experience.
EXPERIENCE:
• Five years of clinician credentialing or payer enrollment along with supervisory experience of at least three years required.
CERTIFICATION/LICENSE:
• No license requirements
“Bricks and mortar do not make a hospital. People do.”- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If youre looking for a leadership opportunity that provides both personal satisfaction and professional growth, apply to join HCA Healthcare as a Director of Clinician Credentialing. Unlock your leadership potential with HCA Healthcare.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
