The Community Health Center of Buffalo, Inc. is seeking an experienced Credentialing & Enrollment Coordinator to join our team. This position is responsible for coordinating the provider onboarding, credentialing and enrollment processes, procedures and protocols for a Federally Qualified Health Center (FQHC). Collaborates with various departments to ensure that network of providers (of all disciplines) meet all necessary FHQC designations, certifications and qualifications to meet FQHC and payor credentialing and enrollment requirements. Involves collaborating with a team, developing strategies, researching regulatory and payor requirements, reviewing contract stipulations, and implementing best practices to streamline the credentialing and enrollment process. Attention to detail and knowledge of industry standards will be crucial in maintaining compliance and accuracy.

Qualifications:

- Bachelor's degree in healthcare administration, business administration, analytics, finance, or a related field, preferred

- Minimum of 3 years of experience in payor, or provider relations, health care analytics, practice administration, compliance, audit, credentialing or enrollment in a healthcare setting, preferably in a FQHC.

- Self-starter, who is focused on delivering maximum results.

- Experience and/or acumen for reading, reviewing and interpreting contract terms and conditions to understand their implication on the credentialing and enrollment process.

- Strong understanding of credentialing principles, regulations, and industry standards and how inefficiencies and/or gaps affect organization revenue, patient and provider experiences.

- Proficient in using credentialing software and systems, experience using CredentialMyDoc a plus

- Proficiency in Microsoft Office Suite- Experience creating high-level reports including creating Excel pivot tables, a plus

- Excellent organizational and time management skills

- Exceptional attention to detail and accuracy

- Strong analytical and problem-solving skills

- Proven ability to facilitate a high-performing team

- Excellent verbal and written communication, interpersonal skills, customer and provider service.

- Ability to work independently and collaboratively in a fast-paced environment.

Responsibilities:

- Develop and implement strategies to improve the credentialing and enrollment process.

- Collaborate with internal stakeholders to ensure provider credentialing and enrollment meets all regulatory, payor and contractual requirements, while preventing and mitigating lost revenue.

- Oversee the management of provider applications, including verification of credentials and qualifications

- Ensure timely completion of credentialing and enrollment activities, including revalidation and updates

- Maintain accurate records and documentation related to provider credentialing and enrollment

- Conduct regular audits to ensure compliance with industry standards and regulations

- Assist in resolving any enrollment-related issues or discrepancies. - Stay updated on changes in regulatory requirements and industry trends related to credentialing and enrollment - Provide guidance and support to the credentialing and enrollment team.

- Generate reports and analyze data related to provider enrollment gaps

If you have a strong background in data warehousing, management, health care analytics, health care contracting, contract lifecycle management, corporate paralegal duties, compliance, credentialing and/or enrollment management and are passionate about continuous process improvement, maintaining compliance and health equity, we would love to hear from you.

The salary range for this position is between $60,000 and $65,000, depending on experience.