Credentialing & Payer Enrollment Specialist

CHI; Houston (TX); On-site; USD 31,009 - 43,793; Full time

Job summary

A leading healthcare organization in Houston is seeking a Credentialing Specialist to verify physician and allied health professional credentials. This role involves managing applications, ensuring timely processing, and maintaining accurate records in the credentialing system. Candidates must hold a High School Diploma or GED. This position offers a competitive hourly pay range from $22.51 to $31.79 based on experience.

Responsibilities

• Verify the credentials of physician and allied health professional applicants.
• Manage the process of sending initial and/or reappointment applications.
• Process appointment/reappointment applications accurately and timely.
• Document receipt of application materials in the credentialing system.
• Ensure all credentialing-related information is up to date in the system.

Education

High School Diploma/GED

Job description

Overview

The role verifies the credentials of physician and allied health professional applicants and re-applicants, and prepares candidates for review by the appropriate clinical Service Chief and Medical Staff Committees.

Responsibilities

• Verify the credentials of physician and allied health professional applicants and re-applicants, and prepare candidates for review by the appropriate clinical Service Chief and Medical Staff Committees.
• Manage the process of sending initial and/or reappointment applications and monitoring their return with required documents.
• Process appointment/reappointment applications in an accurate, thorough, and timely manner; clearly and succinctly communicate reappointment status to applicant in writing.
• File appointment/reappointment applications and other communications as needed.
• Prepare files and other documents, as requested, for review and evaluation by the clinical Service Chief and Credentials Committee in an accurate, consistent, professional, and organized manner.
• Perform third-party verifications of submitted material as required by department policy, medical staff policy, and the Bylaws of the Medical Staff.
• Document receipt of application materials and verifications in the credentialing system (ECHO) (e.g., Texas Medical License, Malpractice Insurance, DEA, Board Certification, DPS, etc.). File copy in physician's file.
• Ensure all credentialing-related information is accurate and up to date in the ECHO system and in the applicant files.
• With the assistance of the Supervisor, utilize ECHO to run reports and ensure all certifications and other tracked information as required is up to date and accurate.

Qualifications

• Education & Experience: High School Diploma/GED required.

Where You'll Work

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

Pay Range

$22.51 - $31.79 /hour