Director of Coding
Panoramic Health
Office
Phoenix, AZ, US
Full Time
Led by physicians, we are the leading integrated provider group focused on improving patient outcomes
Our priority is healthy patients
We deliver better outcomes for patients and lower costs for everyone. We are kidney care’s leading, integrated, provider group which uniquely qualifies us to provide end to end kidney care. We keep patients healthier, longer- at home and out of the hospital. Our clinical engagement and understanding of chronic kidney disease ensures better care and outcomes across the spectrum of CKD-ESRD patients.
Role is Virtual 8am-5pm
The Credentialing Director will oversee the credentialing operations by serving as the subject matter expert in the regulatory and operational requirements of credentialing, re-credentialing, delegated credentialing, and expirable data management. This position supervises the first line of contact for internal and external coordination for the department, sets standards for the department and will lead the process to achieve NCQA certification.
Duties and Responsibilities
1. Provides leadership to establish credentialing best practices and oversee the credentialing process to meet targeted go-live dates for new/existing health plan partners
2. Develops processes for scaling operations and summarizes the complexity of data and operations into clear explanations
3. Supports the manager with the supervision of the credentialling team members including hiring qualified candidates, work allocation, training, performance evaluation and management, staffing ratios, etc.
4. Identifies and implements process efficiencies to ensure a streamlined approach to credentialing
5. Develops and implements a quality program to ensure accuracy of information and timeliness of submissions
6. Provide oversight to the offshore team
7. Supports credentialing regulatory activities, including auditing partners and reporting and risks in the network to regulators and leadership
8. Provides analytical support and leads the process of collecting, analyzing, and reporting credentialing metrics
9. Research government and state requirements for credentialing in new locations and states
10. Collaborate with other leaders to identify issues and opportunities that lead to achieving department and company goals
11. Builds relationships with insurance plans and confirms that the credentialing process is current based on insurance requirements
12. Perform other duties and responsibilities as required, assigned, or requested
Secondary Duties and Responsibilities
1. Assists with gathering billing information needed for new contracts
2. Performs other related duties as assigned or needed for business continuity
Functional and Technical Competencies
• Proficiency with Microsoft Office Suite.
• Knowledge of CAQH, NPDB, OIG and other regulatory agencies.
• Knowledge and experience with health plan transaction sets including benefits.
• Ability to communicate effectively and clearly with all internal and external customers.
• Detail-oriented with excellent follow up.
• Solutions-minded, compliance-minded, and results-oriented.
• Knowledge of Medicare Secondary Payor.
Education/Training and Certification, Licensure, Registration Requirements
• Bachelor’s degree in business or related field and/or equivalent work experience.
Experience
• Minimum of 5 years of credentialing and/or provider enrollment experience in a medical setting at a supervisory level.
• Minimum of 10 years of Medicare, Medicaid, and Commercial Insurance credentialing experience.
• Experience using credentialing software.
Environment and/or Physical Factors
• Extensive telephone and computer usage.
• Use of computer mouse requires repetitive hand and wrist motion.
• Time off restricted during peak periods.
• Regular reaching, grasping, and carrying of objects.
• Must be able to lift up to 15 pounds at a time.
Desired Qualifications
• Prefer Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS).
• Understanding of the direct impact of credentialing on healthcare providers and their practices.
• Knowledge of Athena medical billing preferred.
• Possess strong organizational and time management skills.
• Detail oriented, professional attitude, and reliable.
• Ability to define, analyze and resolve issues quickly and accurately.
• Ability to interact with internal and external customers in a professional manner.
• Ability to manage multiple priorities successfully and drive results.
• Ability to communicate effectively both verbally and in writing.
The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment
For information about our Privacy Policy, please visit here
Our priority is healthy patients
We deliver better outcomes for patients and lower costs for everyone. We are kidney care’s leading, integrated, provider group which uniquely qualifies us to provide end to end kidney care. We keep patients healthier, longer- at home and out of the hospital. Our clinical engagement and understanding of chronic kidney disease ensures better care and outcomes across the spectrum of CKD-ESRD patients.
Role is Virtual 8am-5pm
The Credentialing Director will oversee the credentialing operations by serving as the subject matter expert in the regulatory and operational requirements of credentialing, re-credentialing, delegated credentialing, and expirable data management. This position supervises the first line of contact for internal and external coordination for the department, sets standards for the department and will lead the process to achieve NCQA certification.
Duties and Responsibilities
1. Provides leadership to establish credentialing best practices and oversee the credentialing process to meet targeted go-live dates for new/existing health plan partners
2. Develops processes for scaling operations and summarizes the complexity of data and operations into clear explanations
3. Supports the manager with the supervision of the credentialling team members including hiring qualified candidates, work allocation, training, performance evaluation and management, staffing ratios, etc.
4. Identifies and implements process efficiencies to ensure a streamlined approach to credentialing
5. Develops and implements a quality program to ensure accuracy of information and timeliness of submissions
6. Provide oversight to the offshore team
7. Supports credentialing regulatory activities, including auditing partners and reporting and risks in the network to regulators and leadership
8. Provides analytical support and leads the process of collecting, analyzing, and reporting credentialing metrics
9. Research government and state requirements for credentialing in new locations and states
10. Collaborate with other leaders to identify issues and opportunities that lead to achieving department and company goals
11. Builds relationships with insurance plans and confirms that the credentialing process is current based on insurance requirements
12. Perform other duties and responsibilities as required, assigned, or requested
Secondary Duties and Responsibilities
1. Assists with gathering billing information needed for new contracts
2. Performs other related duties as assigned or needed for business continuity
Functional and Technical Competencies
• Proficiency with Microsoft Office Suite.
• Knowledge of CAQH, NPDB, OIG and other regulatory agencies.
• Knowledge and experience with health plan transaction sets including benefits.
• Ability to communicate effectively and clearly with all internal and external customers.
• Detail-oriented with excellent follow up.
• Solutions-minded, compliance-minded, and results-oriented.
• Knowledge of Medicare Secondary Payor.
Education/Training and Certification, Licensure, Registration Requirements
• Bachelor’s degree in business or related field and/or equivalent work experience.
Experience
• Minimum of 5 years of credentialing and/or provider enrollment experience in a medical setting at a supervisory level.
• Minimum of 10 years of Medicare, Medicaid, and Commercial Insurance credentialing experience.
• Experience using credentialing software.
Environment and/or Physical Factors
• Extensive telephone and computer usage.
• Use of computer mouse requires repetitive hand and wrist motion.
• Time off restricted during peak periods.
• Regular reaching, grasping, and carrying of objects.
• Must be able to lift up to 15 pounds at a time.
Desired Qualifications
• Prefer Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS).
• Understanding of the direct impact of credentialing on healthcare providers and their practices.
• Knowledge of Athena medical billing preferred.
• Possess strong organizational and time management skills.
• Detail oriented, professional attitude, and reliable.
• Ability to define, analyze and resolve issues quickly and accurately.
• Ability to interact with internal and external customers in a professional manner.
• Ability to manage multiple priorities successfully and drive results.
• Ability to communicate effectively both verbally and in writing.
The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. The company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment
For information about our Privacy Policy, please visit here
Director of Coding
Office
Phoenix, AZ, US
Full Time
August 5, 2025