Credentialist Specialist

Tesseris Billing & Credentialing Partners, LLC; El Paso (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

Tesseris Billing and Credentialing Partners, LLC is seeking a Full-Time Credentialing Specialist to manage provider credentialing and payer enrollment. The role involves handling credentialing from document collection to approval and coordinating with the billing team on enrollment impact.

The ideal candidate will have experience with CAQH, Medicare PECOS, and payer portals, and must maintain accurate records while meeting deadlines. Strong communication skills are essential.

Qualifications

• Experience with healthcare provider credentialing and payer enrollment.
• Familiarity with CAQH, Medicare PECOS, and commercial payer portals.
• Ability to manage multiple applications, meet deadlines, and maintain accurate records.
• Strong written and verbal communication skills and the ability to explain processes clearly.

Responsibilities

• Manage credentialing and recredentialing for physicians and other healthcare providers, from collecting documents through confirming approval.
• Prepare and submit initial payer enrollment applications, group affiliations, revalidations, and provider or practice updates, as applicable.
• Maintain provider profiles and supporting documentation in CAQH, Medicare PECOS, payer portals, and internal tracking systems, as applicable.
• Follow up with payers, resolve missing information or application discrepancies, and verify approval and effective dates.
• Track application status, outstanding items, and renewal deadlines. Provide regular updates to leadership and coordinate with the billing team when enrollment issues affect claims.
• Handle confidential provider information and documents in accordance with company procedures.

Skills

Healthcare credentialing

Payer enrollment

Documentation management

Communication

Tools

CAQH

Medicare PECOS

Payer portals

Job description

Full -Time Credentialing Specialist

Tesseris Billing and Credentialing Partners, LLC
Schedule: 40 hours per week

Tesseris Billing and Credentialing Partners, LLC is seeking a Credentialing Specialist to manage provider credentialing and payer enrollment.

Key responsibilities

• Manage credentialing and recredentialing for physicians and other healthcare providers, from collecting documents through confirming approval.

• Prepare and submit initial payer enrollment applications, group affiliations, revalidations, and provider or practice updates, as applicable.

• Maintain provider profiles and supporting documentation in CAQH, Medicare PECOS, payer portals, and internal tracking systems, as applicable.

• Follow up with payers, resolve missing information or application discrepancies, and verify approval and effective dates.

• Track application status, outstanding items, and renewal deadlines. Provide regular updates to leadership and coordinate with the billing team when enrollment issues affect claims.

• Handle confidential provider information and documents in accordance with company procedures.

Qualifications

• Experience with healthcare provider credentialing, payer enrollment, or both.

• Familiarity with CAQH, Medicare PECOS, and commercial payer portals.

• Ability to manage multiple applications, meet deadlines, and maintain accurate records.

• Strong written and verbal communication skills and the ability to explain processes clearly to staff.

Experience enrolling providers with Texas Medicaid, adding providers to existing groups.