Credentialing & Payer Enrollment Coordinator

Catholic Health Initiatives; Houston (TX); On-site; USD 34,000 - 48,000; Full time

Job summary

Baylor St. Luke's Medical Center is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers. The role involves managing daily credentialing operations, resolving non-responsive providers, and ensuring timely completion of credentialing activities.

The candidate should understand credentialing regulations and possess strong organizational and communication skills to handle complex administrative tasks and maintain provider compliance.

Qualifications

• High School Graduate and at least 1 year of experience in medical staff services, hospital administrative department or credentialing verification organization.
• High School GED General Studies and at least 1 year of experience in medical staff services, hospital administrative department or credentialing verification organization.
• Comparable healthcare or managed care work experience may be considered and
• None, upon hire

Responsibilities

• Initiates and coordinates collection of primary source information for credentialing.
• Conducts analysis of primary source documentation for qualifications/competencies.
• Facilitates review and assessment of documentation for each application.
• Serves as Central Verification Office (CVO) primary contact for practitioners.
• Maintains a secure and current database of physician and Allied health professional information.
• Escalates concerns regarding credentialing documents and timeliness of verification.
• Monitors and maintains all required expirables.

Skills

Organizational skills

Communication skills

Credentialing knowledge

Education

High School Graduate General Studies

High School GED General Studies

Tools

MSOW

Cactus

Job description

Baylor St. Luke's Medical Center is seeking a Credentialing Professional to coordinate credentialing, re-credentialing, and payer enrollment for providers. The role involves managing daily credentialing operations, resolving non-responsive providers, and ensuring timely completion of credentialing activities.

The candidate should understand credentialing regulations and possess strong organizational and communication skills to handle complex administrative tasks and maintain provider compliance.