Credentialing & Payer Enrollment Specialist

CHI; Houston (TX); On-site; USD 31,000 - 44,000; Full time

Job summary

St. Joseph Health in the Brazos Valley seeks a Credentialing Professional to coordinate credentialing, re-credentialing and payer enrollment for providers in line with delegated agreements and regulatory requirements.

You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the medical staff office to ensure timely and compliant credentialing and enrollment processes.

Qualifications

• High School Graduate General Studies, upon hire.
• High School GED General Studies, upon hire.
• None, upon hire.

Responsibilities

• Manage the process of sending initial and/or reappointment applications and monitoring their return with required documents
• Responsible for processing 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 communication as needed
• Prepare files other documents, as requested, for review and evaluation of the clinical Service Chief and Credentials Committee in an accurate, consistent, professional, and organized manner
• Perform 3rd 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

Education

High School Graduate General Studies

High School GED General Studies

None, upon hire

Job description

St. Joseph Health in the Brazos Valley seeks a Credentialing Professional to coordinate credentialing, re-credentialing and payer enrollment for providers in line with delegated agreements and regulatory requirements.

You will manage daily credentialing operations, resolve non-responsive providers, and collaborate with clinic managers and the medical staff office to ensure timely and compliant credentialing and enrollment processes.