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Reworks Solution logo
Reworks Solution

Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.

Healthcare Compliance Manager

Location

South Africa

Posted

54 days ago

Salary

0

Seniority

Lead

No structured requirement data.

Job Description

Healthcare Compliance Manager

Reworks Solution

Role Description ReWorks Solutions is seeking a dedicated Credentialing Manager specializing in Applied Behavior Analysis (ABA) to lead and manage our credentialing operations. This role requires a proactive professional to ensure our providers meet all necessary credentialing requirements with insurance payers and regulatory bodies, maintaining compliance and facilitating smooth onboarding processes. - Manage and lead the ABA credentialing team to ensure timely completion of credentialing and recredentialing tasks. - Maintain and develop relationships with insurance payers, providers, and regulatory agencies. - Stay current on ABA credentialing standards, payer policies, and regulatory requirements. - Identify and implement process improvements to increase efficiency. - Provide training and support for credentialing staff to uphold best practices. - Monitor credentialing metrics and generate regular compliance reports. - Coordinate with HR and leadership on provider onboarding and terminations relating to credentialing. - Handle audits and respond to credentialing inquiries from external entities. Qualifications - Bachelor’s degree in healthcare administration, business, or related field preferred. - 3-5 years of experience in credentialing, preferably within ABA or behavioral health. - Leadership experience in managing credentialing teams or projects. - Strong understanding of insurance payer credentialing processes and regulatory compliance in ABA. - Excellent organizational, multitasking, and communication skills. - Proficiency with credentialing software, Microsoft Office, and database management. - Ability to work effectively in a remote environment and collaborate with a diverse team. Benefits - Comfortable working U.S. hours - Remote work from home Fraud Disclaimer ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.

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