Payer Credentialing Expert for Providers

Paycom; Southlake (TX); On-site; USD 52,000 - 70,000; Full time

Job summary

Paycom is seeking a credentialing specialist to process credentialing and re-credentialing tasks for its provider/practitioner network. You will gather information, perform primary source verification, and monitor status to ensure accuracy and timely renewals.

In a fast-paced office environment, you will maintain provider databases, ensure compliance with policies and regulatory requirements, and collaborate with health plans and hospitals to facilitate enrollments.

Qualifications

• High school diploma or equivalent required.
• 3–5 years credentialing experience preferred.
• Understanding delegated credentialing requirements for health plans.
• Experience with primary source verification and associated credentialing sources.

Responsibilities

• Process credentialing and re-credentialing tasks in accordance with policies and regulatory requirements.
• Gather and submit credentialing information for provider networks.
• Monitor and update provider status and credentials to ensure accuracy and renewals.
• Set up and maintain provider information in credentialing databases and systems.
• Track license and certification expirations and ensure timely renewals.
• Ensure compliance with organizational policies and regulatory requirements.

Skills

Strong presentation skills

Excellent communication

Proficient computer skills

Multi-tasking ability

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Paycom is seeking a credentialing specialist to process credentialing and re-credentialing tasks for its provider/practitioner network. You will gather information, perform primary source verification, and monitor status to ensure accuracy and timely renewals.

In a fast-paced office environment, you will maintain provider databases, ensure compliance with policies and regulatory requirements, and collaborate with health plans and hospitals to facilitate enrollments.