Provider Credentialing & Records Specialist

Altus Community Healthcare; Houston (TX); On-site; USD 42,000 - 62,000; Full time

Job summary

Altus Community Healthcare is seeking a Medical Credentialing Specialist to maintain active provider status by completing credentialing packages for commercial payers, Medicare and Medicaid. The role also gathers and maintains patient records and reports health information for standards compliance.

You will handle provider enrollment, license verification, and charting, supporting the Compliance department.

Qualifications

• Associate's degree or equivalent required; six months to one year related experience may be accepted.
• Experience with provider enrollment processes and health plan enrollment is preferred.

Responsibilities

• Process provider applications and enrollments with health plans and payors to ensure timely credentialing.
• Maintain provider enrollment database and update provider information as needed.
• Enter and maintain credentialing files, contracts, and updates.
• Complete Medicare enrollments via PECOS and coordinate with MACs.

Skills

Data entry

Attention to detail

Communication

Education

Associate's degree

Tools

PECOS

Job description

Altus Community Healthcare is seeking a Medical Credentialing Specialist to maintain active provider status by completing credentialing packages for commercial payers, Medicare and Medicaid. The role also gathers and maintains patient records and reports health information for standards compliance.

You will handle provider enrollment, license verification, and charting, supporting the Compliance department.