Credentialing Coordinator | Full Time

Peterson Health

  • Kerrville, TX
  • 19 days ago

    Highlights

    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. Recognized as one of the nation's Top 20 Rural and Community Hospitals and the only Texas hospital to earn this distinction, Peterson is also Magnet® designated for nursing excellence and has been named one of Modern Healthcare's Best Places to Work in Healthcare for six consecutive years.

    Numbers & Facts

    LocationKerrville, TX

    Description

    Who we are:

    Peterson Health is an independent, not-for-profit healthcare organization located in Kerrville, Texas, in the heart of the Texas Hill Country. Recognized as one of the nation's Top 20 Rural and Community Hospitals and the only Texas hospital to earn this distinction, Peterson is also Magnet® designated for nursing excellence and has been named one of Modern Healthcare's Best Places to Work in Healthcare for six consecutive years. Together, these achievements reflect our commitment to exceptional, compassionate, patient-centered care and a culture where team members thrive.

     
    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.
     

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