Summary:  The Credentialing & Revenue Cycle Analyst facilitates accurate and timely credentialing and enrollment efforts for CPC's providers and supports the administration and optimization of revenue cycle-related software applications, as well as the execution and analysis of certain reporting and troubleshooting activities. This position is an in-office on-site environment.

Education: High School Diploma or GED required. Degree or certificate in health information management, medical billing/coding, or a related field strongly preferred. Data analytics, database management, and/or SQL knowledge a plus.

Experience: At least two (2) years' experience in credentialing, health information management, medical billing, health informatics, or a related field, is required. Additional experience specifically in medical provider credentialing, payer enrollment, and/or data analytics is strongly preferred.

Essential Job Functions

Credentialing

• Facilitates new provider credentialing and established provider re-credentialing activities
• Keeps all applicable credentialing databases and spreadsheets up to date
• Monitors expiration dates and assists with the renewals of provider licenses, certifications, etc.
• Stays up to date on relevant state and federal regulations, etc.
• Maintains payer rosters, including necessary communication with health plan provider representatives
• Cooperates with other revenue cycle staff to identify and resolve credentialing- and enrollment-related issues

Revenue Cycle Applications

• Designs, executes, and analyses recurring and ad hoc reporting, in support of overall revenue cycle efficiency and effectiveness
• Assists with the administration and optimization of revenue cycle-related software applications
• Contributes to special projects that improve or correct revenue cycle activities, as necessary
• Performs additional duties and responsibilities, as necessary.
• Maintains confidentiality of all protected health information (PHI) and personally identifiable information (PII).
• Performs job in compliance with organization policies and procedures as well as community standards and applicable laws.
• Promotes positive public relations to patients, visitors, families, physicians, and others. Exhibits characteristics consistent with CPC values for quality, respect, teamwork, and pride.

Knowledge, Skills, and Abilities:

• Eager and able to embody CPC's mission, especially to serve joyfully
• Willing and ready to work collaboratively for the good of the team
• Knowledge of health system, providers, licensing, and credentialing processes
• Able to manage time, keep timelines and, at times, work well under pressure
• Very high attention to detail
• Advanced organizational and problem-solving skills
• Able to communicate effectively and succinctly, in writing and verbally
• Strong overall computer skills and intermediate knowledge of Microsoft Word and Excel
• Able to work with diverse populations.
• General ability to navigate websites and payer portals

Equipment Operated: Standard office equipment such as phone, computer, printers, copiers, and fax machines

Work Environment: Position is on-site and primarily in a well-lighted office environment. 

Mental/Physical Requirements: While performing the duties of this job, the employee is regularly required to talk or hear.  The employee is primarily sitting at a desk utilizing a computer and phones.

DISCLAIMER

The above information is intended to describe the general nature and level of work being performed by people assigned to this job. It is not intended to be an exhaustive list of responsibilities, duties and skills required of personnel so classified. Examples listed do not preclude the performance of other duties similar in nature or in level of complexity