ASC Credentialing & Payer Operations Lead

GI Alliance; Southlake (TX); On-site; USD 90,000 - 130,000; Full time

Job summary

GI Alliance is seeking a Manager, ASC Credentialing and Payer Operations to lead credentialing and recredentialing for the ASC network with major payers. You will supervise timely submissions, verify primary source documents, and ensure compliance with payer guidelines and HIPAA.

You will maintain the credentialing database, coordinate with payer representatives, internal teams, and providers, and prepare CAQH, Availity, NPPES, PECOS, and Texas Medicaid applications.

Qualifications

• Minimum five (5) years of ASC credentialing experience.
• Proficiency with Microsoft Office (Word & Excel) required.
• Experience with CAQH, NPI, PECOS, and payer portals preferred.
• Knowledge of state and payer-specific guidelines.
• Ability to manage multiple tasks and maintain confidentiality.

Responsibilities

• Oversee credentialing and recredentialing applications with payers and ASC locations.
• Collect primary source verification documents (licensing, certifications, liability).
• Maintain credentialing database and ensure information is up to date.
• Notify staff on credentialing completion and plan participation status for scheduling and billing.
• Prepare CAQH, Availity, and standardized credentialing applications.
• Complete NPPES (NPI), PECOS (CMS), and Texas Medicaid applications.
• Verify all ASC credentialing requirements are met.
• Submit provider rosters to health plans monthly and communicate changes.

Skills

ASC credentialing

Payer credentialing

Credentialing processes

Relationship management

HIPAA compliance

Documentation management

Tools

Microsoft Office

Job description

GI Alliance is seeking a Manager, ASC Credentialing and Payer Operations to lead credentialing and recredentialing for the ASC network with major payers. You will supervise timely submissions, verify primary source documents, and ensure compliance with payer guidelines and HIPAA.

You will maintain the credentialing database, coordinate with payer representatives, internal teams, and providers, and prepare CAQH, Availity, NPPES, PECOS, and Texas Medicaid applications.