Talent Pool: Professional/Management
| This position is responsible for enrolling/credentialing the Health System?s individual providers in government (Medicare/Medicaid, etc.) and managed care plans as required by the regulations or contracts governing these plans. |
| Complete credentialing and re-credentialing applications for these individuals in an accurate and timely manner -------------------------------------------------- Maintain a database of physicians and non-physician practitioners (CRNA•s, physician assistants, nurse practitioners, etc.) for whom the Health System is responsible for billing and/or managed care contracting. The database should contain participation status with government programs and managed care plans, effective dates of participation, re-enrollment deadlines and requirements, provider numbers and credentials -------------------------------------------------- Coordinate payor enrollment activities with internal credentialing functions performed by Medical Staff Services. Notify contracted payors of changes to provider panels -------------------------------------------------- Maintain an understanding of licensure and certification requirements in order to coordinate the enrollment process related to these activities -------------------------------------------------- |
| EDUCATION: |
| Bachelors, Preferred |
| EXPERIENCE: |
| 3 years, Preferred 3 years experience in Provider Credentialing preferred. CACTUS experience preferred. |
| LICENSURE/CERTIFICATION/REGISTRY/LISTING: |
| REQUIRED PREFERRED |
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