Director, Credentialing

Company Overview: CareCloud is a leading provider of technology-enabled services and solutions that redefine the healthcare revenue cycle. We provide technology-enabled revenue cycle management and a full suite of proprietary cloud-based solutions to healthcare providers, from small practices to enterprise medical groups, hospitals, and health systems, throughout the United States. Healthcare organizations today operate in highly complex and regulated environments. Our suite of technology-enabled solutions helps our clients increase financial and operational performance, streamline clinical workflows, and improve the patient experience. Job Summary: CareCloud is currently seeking a full-time Director of Credentialing with extensive experience to join our team. The Director of Credentialing will play a crucial role in ensuring the timely submission of provider enrollments to healthcare insurance carriers. This position requires building strong relationships with clients, carriers, and staff and is vital to the company's revenue cycle. As a key member of the operations team, the Director of Credentialing will be involved in various departments and frequent client interaction. Additionally, they will be responsible for crafting and presenting analyses and recommendations to upper management to improve organizational effectiveness. Essential Duties and Responsibilities: Accountable for optimizing the quality and efficiency of the Provider Enrollment Dept. onshore and offshore staffs Responsible for ensuring the dept. possesses relevant and current knowledge of enrollment requirements of various health plans and states, NY, NJ, CT, PA, FL, CA and many other states Oversees and directs all daily activities in support of the departmental goals and objectives, and is responsible for directing, motivating, monitoring, measuring and development of employees Serve as the primary point-of-contact for day-to-day Provider Enrollment issues with clients and staff within internal and external dept. Responds to and resolves unusual problems or delays in enrollment process (including claim denials related to enrollment matters) Assess the allocation of resources, ensuring a balanced workload for enrollment staff Review and maintain credentialing dashboards and analytical reporting for all clients Identifies areas of improvement or challenges and escalates to VP of Ops if resolutions are not achieved Develops and maintains department SOPs Conduct routine staff meetings with credentialing staff and clients Collaborates and supports external departments on client Credentialing necessities Interacts with Sales Dept. on prospective credentialing clients Required Knowledge, Skills and Abilities: CPMSM and/or CPCS preferred 3+ years of Management experience - preferably at the director or senior manager level 5+ years of progressive experience with enrollment, credentialing and payer contract negotiations Working knowledge of provider enrollment structure and processes Ability to interact and communicate with individuals at all levels of the organization The ability to utilize software applications; Word, Excel, Power Point, Outlook and Credentialing Software Demonstrates excellent written and oral communication with staff, clients, management, and all professionals. Presents excellent analytical skills and interpretation of data Possesses strong leadership presence Education and Experience: Bachelor’s Degree or equivalent experience Supervisory Responsibilities: Credentialing team Travel Required: 20% Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. EEO Statement: CareCloud is committed to equal employment opportunity for all qualified individuals. We are committed to complying with all federal, state, and local laws providing equal employment opportunities,and all other employment laws and regulations. CareCloud prohibits discrimination against employees and applicants because of race, religion, color, gender (including gender or sexual identity or expression), age, national origin, ancestry, marital status, sexual orientation, physical or mental disability, medical condition including genetic characteristics, genetic information, veteran status, or other characteristics protected by applicable law. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position requires the ability to occasionally lift office products, equipment, and supplies, up to 20 pounds. ADA Statement: CareCloud is fully compliant with the ADA and will provide reasonable accommodations to enable individuals with disabilities to perform essential job functions under the guidance of the ADA. Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that you may be asked by your managers to perform other duties. Benefits: CareCloud recognizes the importance of benefits and wellness for employees and their families. In addition to time off to support work-life balance and enjoyment, we offer a comprehensive benefits package designed for employees’ individual needs (including domestic partners). Healthcare – A choice of medical plans designed to meet your individual needs Dental & Vision 401(K) with company match Flexible spending accounts (health & dependent care) Company-paid life insurance (accidental and supplemental coverage at low cost) Company-paid Short and Long term disability Voluntary benefits Flexible PTO and Paid Holidays