About WellLife Network: WellLife Network is a leading health and human services organization dedicated to supporting individuals and families across New York City and Long Island. Recognized as a 2023 top-rated nonprofit, WellLife Network empowers people to overcome life’s challenges and achieve greater independence, well-being, and inclusion. We offer a comprehensive suite of programs spanning mental health, developmental disabilities, substance abuse, housing, and employment support, all grounded in a commitment to compassionate, high-quality care. Central to our mission is an unwavering dedication to diversity, equity, inclusion, and belonging (DEIB) within our organization and in the communities we serve. As a trusted community partner, WellLife Network fosters a nurturing environment where everyone has the opportunity to thrive and realize their fullest potential.

Position Summary: In this role, the candidate, under the supervision of the Revenue Cycle Manager, will be responsible for ensuring healthcare providers meet the necessary qualifications, regulatory standards, and compliance requirements to deliver services within the organization. This position involves overseeing the credentialing process, verifying provider credentials, and maintaining accurate records to ensure the organization remains compliant with all legal and regulatory standards. Additionally, the candidate will support various tasks related to revenue cycle management. The ideal candidate will possess a strong understanding of credentialing procedures and have experience in revenue cycle management.

Essential Accountabilities:

Manage and oversee the credentialing and re-credentialing process for providers, ensuring timely and accurate submissions to regulatory bodies (e.g., Medicare, Medicaid, and commercial payers). Collect, verify, and ensure completion of all necessary documentation for credentialing applications (licenses, certifications, insurance, etc.). Maintain up-to-date records of all credentialing and re-credentialing activities, ensuring providers meet compliance standards and that provider data is included in payer rosters and directories. Monitor and track credentialing status for new and existing providers, addressing any discrepancies or delays in the process. Ensure all credentialing applications are completed accurately and within set timelines to minimize delays in provider enrollment and revenue generation. Stay current with healthcare regulations and payer guidelines to ensure compliance with credentialing requirements. Act as a liaison between providers, insurance companies, and internal teams, offering support and addressing any questions. Stay informed of the latest billing guidelines for Medicare, Medicaid, MCOs, commercial insurance, and self-pay to ensure alignment with credentialing requirements. Other Revenue Cycle Management duties as assigned.