Manager of Provider Credentialing and Data Interchange

Borgess Health, located in Kalamazoo, MI, includes more than 132 sites of care and 67 satellite clinics in 15 southern Michigan cities.  The Borgess Health members form a health care network that offers a complete continuum of services to the 1.1 million people living in 11 counties in southwest and south-central Michigan. 

 

The Manager of Provider Credentialing and Data Interchange is located at Borgess Ambulatory Care (BAC) which is part of the Borgess Health system.  BAC offers several different practice sites serving southwest MI. offering Family Practice, Internal Medicine, Pediatrics, Behavioral Medicine, Extended Care, Women's Health, Research and much more.

 

This position directly reports to the CFO, BAC.  The primary objective will be to provide management oversight and administration of the credentialing and enrollment process for medical providers in various Borgess Health networks.  This role will ensure that all accreditation processes and procedures are completed in accordance with established regulatory and policy requirements.  Additional responsibilities will include facilitating the administrative requirements of the Physician Credentialing Committee, oversight of the training and education function of clinic and Patient Financial Services personnel on the billing software system (Misys Visions), and ensures accurate and timely payments for provider services.

 

Position QualificationsBachelor’s degree in Business related field required.Minimum of five years medical office billing experience required, preferably for a multi-site physician practice.Three or more years of management/supervisory experience required.Knowledge of provider credentialing, accreditation regulations, policies, guidelines, and national and state standards including NCQA, JCAHO or URAC.Knowledge of Misys Visions system or similar professional billing software system. Knowledge of revenue cycle functions for a physician office.  Knowledge of physician practice management, personnel management, and third-party reimbursement processes.  Knowledge of governmental regulations and compliance requirements. 

If you are prepared to meet the challenge offered at Borgess and have a desire to advance your career please submit qualifications to Shelly Cichy, Recruiter via email at shellycichy@borgess.com   Additional information can be found by visiting www.careers.borgess.com.