The Account Manager contributes to the ongoing achievement of the organization's goals through ensuring providers are credentialed using vetted processes and procedures. Identifies, analyzes, and resolves information discrepancies, and time gaps that could adversely affect a facility's ability to credential and/or privilege providers. Partners with medical staff, credentialing and privileging committees, and other key stakeholders to ensure compliance with credentialing standards. Responsible for maintaining accurate and comprehensive data in the credentialing software.

The Account Manager must have overall knowledge of the credentialing and privileging process, know the required credentials for health care professionals and utilize the appropriate resources to complete Primary Source Verification (PSV) and all others requested. Account Managers demonstrate a thorough knowledge on credentialing policies, guidelines, and regulations for the CVO credentialing process.

Duties and Responsibilities:

• Assists Manager in all credentialing aspects of regulatory reviews including, but not limited to, State and Federal regulations, NCQA, CMS, and TJC, URAC. Prepares or reviews all pre-audit documents to assure accuracy
• Participates in the staff interview process and assures that all recommendations are implemented to assure continued compliance
• Responsible for fostering effective relationships and communications with operational leadership, physicians, revenue cycle, payers, hospital leaders, and hospital partners
• Processing of provider applications and re-applications
• Maintains accurate provider profiling system data
• Communicate with client representatives
• Assists Manager with staff meetings to discuss file progress and any potential delays
• Responds to requests for provider information • Enforces regulatory compliance and quality assurance
• Support, in conjunction with the QA Team, any adverse action activities in accordance with regulations and policies
• Prepare documentation, conduct, and conclude credentialing and privileging meetings with various clients as described contractually
• Work, in conjunction with leadership, to identify potential 'pitfalls' in the CVO credentialing process
• Meet productivity standards as outlined in CVO and client metrics

Skills Required:

• Strong knowledge of industry standards, to include but not limited to: CMS, TJC, NCQA, AAAHC and DNV
• Strong knowledge of the Microsoft office suite to include Excel
• Affinity to multi-tasking
• Strong interpersonal skills-works well with a team
• Strong oral and written communication skills
• Strong conflict resolution skills
• Exceptional attention to detail
• Exceptional analytical skills
• Customer interaction experience

Qualifications Required:

Every organization has a culture, whether they mean to or not, so why not be intentional about it?

Together, if we shape our intentions, actions, and interactions around a common, purposeful culture, we are able to quickly achieve more, attract others who help realize our goals, and thrive in our professional relationships.

• Bachelor's Degree and/or equivalent work experience
• At least 3+ years of experience in medical credentialing

Pay: $50,000 - 65,000/yr DOE

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Legal authorization to work in the U.S. is required. Effective January 2020, we will not sponsor individuals for employment visas, now or in the future, for this job opening. **Existing internal employees on immigration through symplr, please connect with the Talent Acquisition team directly.

About symplr:

As a leader in healthcare operations solutions, we empower healthcare organizations to navigate the complexities of integrating critical business operations. Our customers are at the heart of everything we do, and they rely on our mission-critical systems to drive better operations and better outcomes.

We are a remote-first company with employees working across the United States, India, and the Netherlands. Guided by values, we focus on teamwork, championing our customers, being rooted in action and outcomes, overcoming challenges, and leading through equality and integrity. Read more about symplr's culture and values at symplr.com/careers.

Perks & Benefits:

• Company Sponsored Medical, Dental & Vision
• Safe Harbor 401K with Employer Matching up to 5%, eligible upon hire with immediate vesting
• HSA Employer Contributions, Employer Paid Life, Short-term and Long-term Disability, and AD&D Insurance Plans
• Generous Time Off Plans, Volunteer Time Off, & 12 Paid Holidays
• Fully Paid Medical Leaves of Absence and Bonding Leaves for new parents
• Tuition Assistance & Continuing Education Reimbursement available
• Additional Employer-Paid Programs: Cleo Family Services, Care@Work Memberships, Headspace Memberships, LifeMart Discounts, and more!

symplr is an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state or local law.

As an ongoing commitment to reasonably accommodate individuals with disabilities, symplr has established alternative methods to complete the application process. Disabled applicants needing assistance are encouraged to call 281.863.9500 if further assistance is required.

To all recruitment agencies: we do not accept resumes or partnership opportunities. Please do not forward resumes to symplr or any of our employees. We are not responsible for any fees related to unsolicited resumes.

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