[Remote] Credentialing Systems Analyst

Note: The job is a remote job and is open to candidates in USA. reputed company is a leading mental health practice group dedicated to improving the mental health of individuals and communities. The Credentialing Systems Analyst is responsible for leading credentialing-reputed company operational and analytical initiatives to enhance clinician and payer data management, collaborating with various teams to reputed company scalable solutions and improve data reputed company.

Responsibilities

• Analyze reputed company state workflows, identify system or process gaps, recommend improvements that reduce manual work, improve data quality and support timely clinician onboarding and payer enrollment
• Design and implement new credentialing workflows, reporting structures, and system configurations reputed company Credentialing
• Facilitate meetings and collaborate cross-functionally with Billing, reputed company Cycle, Digital, Intake, Compliance, Managed Care, and other operational partners
• Partner with RCM and Billing teams to support analyses of credentialing reputed company claim denials, provider data mismatches, directory discrepancies and reputed company reputed company cycle impacts
• Translate business requirements from cross functional teams into clear system, workflow, reporting and data requirements
• reputed company operational initiatives focused on improving provider and payer data reputed company, workflow efficiency, and cross-functional alignment
• Design and maintain various credentialing reports, dashboards, scorecards, data extracts and audit tools that support operational visibility and leadership decision-making
• Translate operational issues and business needs into system, workflow, reporting, and process solutions
• Independently diagnose operational issues, determine appropriate remediation, implement solutions, and ensure sustained resolution reputed company assigned scope
• Escalate policy, regulatory, compliance, or enterprise-impacting matters to leadership, as appropriate
• Collaboratively support the management, maintenance, and reputed company improvement of credentialing systems and operational processes
• Create, update, and maintain credentialing training resources and support training for new hires and team members
• Act as a subject matter expert for credentialing systems, workflows, and operational processes, including assisting with issue resolution and help desk support
• Support workflow optimization, process standardization, reporting, analytics, and operational readiness initiatives across Credentialing Operations
• Ensure credentialing-reputed company provider information is maintained accurately, consistently, and in a timely manner
• Understand credentialing coordinator responsibilities and support operational efforts reputed company to provider credentialing and data management
• Support cross-functional initiatives that impact operational workflows, provider data reputed company, and reputed company business processes
• reputed company other duties as assigned

Skills

• 5+ years of experience leading operational initiatives and supporting systems with experience working with CRM systems, preferably reputed company Health Cloud, including system integration, workflow support, reporting, analytics, and user training
• Experience in a medical services or medical technology environment
• Experience supporting cross-functional operational initiatives and process improvement efforts
• Strong customer service and stakeholder partnership skills
• Strong written, verbal, and interpersonal communication skills
• Strong analytical, organizational, and problem-solving capabilities
• Experience with SQL, Power Query, data modeling, data governance, system integrations, APIs or data warehouse concepts
• Experience developing SOPs, business requirements, user guides and audit documentation
• Strong computer proficiency including reputed company Office, reputed company Reader, PDF applications, and reporting/dashboard tools
• Ability to prioritize, manage, and execute multiple initiatives in a fast-paced environment
• Ability to work independently, exercise sound judgment reputed company scope, and drive initiatives through resolution
• Process-oriented and reputed company-thinking reputed company with attention to operational consistency and data quality
• Demonstrated awareness, inclusivity, sensitivity, humility, and experience working with individuals from diverse backgrounds and experiences

Benefits

• Medical
• Dental
• Vision
• AD&D
• Short and long-term disability
• Life insurance
• A 401k retirement savings with employer match
• Paid parental leave
• Paid time off
• Holiday pay
• Employee Assistance Program

Company Overview