Credentialing & Reimbursement Assistant Manager

This position is responsible for assisting with the overall management and leadership of the Credentialing and Reimbursement Departments.
This position will ensure accurate and timely credentialing, investigate payer setup issues, and is responsible for the training and development of the team.
ESSENTIAL DUTIES AND RESPONSIBILITIES Ensure timely, efficient, and accurate credentialing and reimbursement of all clients Develop credentialing and reimbursement workflows, protocols, and procedures Identify, and act on, opportunities to improve credentialing and reimbursement activities Develop and maintain processes making provider statuses readily available to Operations Monitor and review payer set up and establish action plans to resolve issues Track license and certification expirations for all providers and ensures timely renewals Monitor daily communications with Medicare, Medicaid, and commercial insurance companies to ensure updates are completed timely Maximize ERAs and EFTs to ensure efficiency Handle onboarding - Money Flow, Banking, EOM funds Prepare and manage money flow calls with clients Manage missing EOB log and Commercial Banking Projects Stay updated on industry and legislative changes Monitor FreshDesk tickets for reimbursement and credentialing Other job-related duties as assigned KNOWLEDGE AND EXPERIENCE PREFERRED Bachelors' degree or equivalent education and experience Minimum of three (3) years Texas Medicaid and Medicare Part B Ambulance credentialing experience.
Fluency on the following websites: CMS, NPPES, DSHS, TMHP, and PALMETTO GBA, PECOS, Dept.
of Labor, SAM, NAVINET Minimum of three (3) years of Texas Medicaid, Medicare Part B, and commercial payer EDI/ERA/EFT and portal set-up experience Knowledge of federal and state insurance laws and their interpretation Knowledge of Microsoft Excel Ability to work within a deadline-intense environment, with strong adaptability to change Demonstrated problem-solving and professional customer service skills Ability to communicate effectively and professionally Detail oriented, organizational and time management skills Ability to prioritize and multi-task High School Diploma/GED required Emergicon requires satisfactory pre-employment drug screen and background check.