• Credentialing Manager

    Location US-FL-Maitland
    Job ID
    Metro Area
    Orlando, FL
    Revenue Cycle Management
    Employment Status
  • Overview

    U.S. Anesthesia Partners (USAP) is the largest single-specialty anesthesia practice in the country with over 4,000 clinical providers and associates.  By joining our team you will participate in a highly collaborative and dynamic environment.  As an organization we are mission focused on delivering the highest quality in patient care and you will be directly supporting our talented clinical team.  We extend this same commitment to quality to our associates and supply tools and resources that will ensure we win in the healthcare marketplace and support of USAP.


    We are proud of our inclusive people culture that supports our associates to perform at their best.  USAP is an equal opportunity employer.  Candidates with physician services or related health care experience is a plus. We offer a competitive benefits package. 


    This position is a customer service-oriented position that will direct the daily activities of the Credentialing and Physician Services departments. Provides direct interaction with Hospital Medical Staff Services and other departments requiring specific Provider related information. In addition, this position will maintain positive relationships with all Surgery and OB offices ensuring that information is provided timely and problem resolution is a seamless process. This position will ensure the integrity of all information provided to facilities and or Government agencies while maintaining the utmost confidentiality.


    ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):



    • Direct the daily activities of the credentialing department.
    • Ensure timely and accurate submission of all data to facilities, government agencies and Managed Care Plans.
    • Review and submit to candidates to the USAP Committee on a monthly basis for new credentialing or re-credentialing evaluations.
    • Work with all facility Medical Staff Services and Central Verification Offices to ensure that USAP is current on all primary verification (documents) and other requirements as dictated by Medical Staff Bylaw Updates.
    • Participate in the yearly malpractice insurance renewal process working closely with the CFO, Quality Management and Risk Management department heads.
    • Ensure that any issues regarding state medical license, Federal Drug Enforcement Administration (DEA), State Department of Public Safety (DPS), or other pertinent agency data are resolved timely and with the utmost confidentiality.
    • Maintain information regarding Continuing Education Opportunities for Providers and oversee data base retention of all Continuing Medical Education (CME) data.
    • Work closely with Physician Recruiter and Human Resources to maintain accurate physician headcount and status of all recruits.
    • Ensure all departmental policies and procedures are documented and maintained on an on-going basis.
    • Maintain customer contacts with all levels of personnel, including physicians, division manager’s executive committee, USAP Senior Management Team and a multitude of external contacts at all levels.
    • Foster a positive work environment and maintain thorough staff retention or recruitment experiences for Credentialing and Provider Enrollment staff. Maintain Departmental budget at or below the yearly projections.
    • Maintain data management and work processes in Credentialing Software application. Experience with Morrisey (Apogee) or similar credentialing applications is preferred.
    • Performs other duties as assigned.



    • Ensure the timely and accurate submission of all Managed Care applications based on USAP Policy and divisional requests.
    • Oversee the maintenance of the Managed Care Grid and all related reports.
    • Act as a liaison between the Central Business Office and managed care entities to ensure the timely review of applications for effective dates.
    • Review potential contracts as requested.
    • Maintain the managed care files and contract histories.
    • Oversee all new provider managed care projects.



    • Direct the daily activities of divisional Physician Service Coordinators.
    • Work with all divisions to develop and maintain facility and patient informational material.
    • Host meetings, luncheons, etc. for Surgeon and OB staff office as needed to respond to concerns and maintain positive relationships.
    • Visit individual Physician offices as needed or requested by divisions.
    • Ensure the monthly reconciliation of physician minutes and or cases for designated divisions.
    • Respond to Physician Office, Facility and Patient Complaints working closely with risk to ensure satisfaction.
    • Manage answering service and call center concerns as needed.
    • Attend division meetings and transcribe minutes as requested.
    • Act as liaison between CBO and providers regarding account reconciliation.
    • Provide after-hour coverage for questions concerns and issues as needed.
    • Represent the organization in a positive professional manner.
    • Adhere to all company policies and procedures.
    • Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures, attend Information Systems security training, and to report information systems security problems when they occur.
    • Staff development through performance evaluations, counseling and disciplinary actions as needed with assigned staff.
    • Facilitate individual and team development that drives positive results.


    US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.


    JOB REQUIREMENTS (Knowledge, Skills and Abilities):

    • Working knowledge of credentialing, managed care and general physician practice management.
    • Direct Credentialing experience related to maintaining appointments and reappointments for a large provider base.
    • Demonstrated ability to work cooperatively with physicians, all staff members and external customers.
    • Strong Leadership, management and organizational skills.
    • Strong attention to detail
    • Overall knowledge of Healthcare
    • Must be able to select, develop, effectively manage and motivate staff.
    • Working knowledge of computers and general patient accounting and credentialing systems.
    • Must possess a pleasant disposition and tolerance for diverse personalities.
    • Ability to set and meet deadlines.
    • Ability to identify and resolve problems effectively.

    License and Certification:

    • Membership in the National Association of Medical Staff Services (NAMSS) is encouraged
    • Certified Provider Credentialing Specialist (CPCS) and membership in the National Association of Medical Staff Services are positive attributes for consideration




    • Bachelor’s degree in business, healthcare administration or relevant field and three to five years of solid Healthcare management experience; or equivalent combination of education and experience.
    • Professional Certification is preferred
    • Three to Five years of direct Physician interaction.
    • Five years of Supervisory/Management experience working


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