Credentialing Coordinator | Full Time

Credentialing Coordinator | Full Time Professional / Management Revenue Cycle

DESCRIPTION

Who we are: Peterson Health is an independent, not-for-profit rural community hospital located in Kerrville, TX- heart of the Texas Hill Country. Peterson was recently named one of the Top 20 rural and community hospitals in the country and the only one in Texas by the National Rural Health Association. Being named one of the Best Places to Work in Healthcare by Modern Healthcare for six consecutive years is a testament to Peterson's commitment to its team and to fulfilling its mission of providing exceptional, compassionate, patient-centered care.

Shift Information:

This position is Full-Time What we offer: Health Insurance 401(k) Dental Insurance Vision Insurance Paid time off Tuition Reimbursement | HPSA Designated Employee Education Scholarships Employee Referral Program Merit Increases Free access to a beautiful onsite fitness facility What you will do: The Credentialing Coordinator is responsible for performing credentials verification for members of Peterson Regional Healthcare Network (PRHCN), and employed/contracted providers of Peterson Health to ensure compliance with standards set forth by the National Committee Quality Assurance (NCQA), Center for Medicare and Medicaid Services (CMS), Texas Medicaid & Healthcare Partnership (TMHP) and contracted payers. This position is responsible for submitting accurate and complete provider organizational and facilities providers enrollment applications, following up with payer credentialing departments and provider enrollment representatives to ensure providers are fully credentialed and loaded as participating with all applicable contracted health plans. The Credentialing Coordinator is accountable for maintaining and disseminating accurate plan participation status reports and billing information to all applicable PRHCN members to maximize collections in the revenue cycle management process.

Preferred Education:

Associates or Bachelor's degree in healthcare management

Required Skills:

Effective communication skills to interact professionally with clinical and financial health care colleagues; intermediate knowledge of

Microsoft Office Preferred Skills:

2+ years managing a provider credentialing system Preferred Licensure /Registration /

Certification:

Certified Provider Credentialing Specialist as offered by the National Association of Medical Staff Services (NAMSS)

Preferred Experience:

Minimum of 2 years experience in payer relations or credentialing with an insurance company, hospital, or other large group of providers.