Credentialing/Contracting Specialist

Houston, TX

Post Date: 12/12/17 Job ID: 00002RKR Industry: Healthcare Pay Rate: 65000.00 - 70000.00
Expanding company based in West Houston has immediate opening for an experienced Credentialing and Contracting Specialist. Position required an experience candidate to perform the following functions on a daily basis:
Credentialing all providers in the practice including Medicare, Medicaid and Managed Care applications
Credential facilities with insurance carriers
Negotiate in-network contracts with insurance carriers for physicians and facilities
Responsible for maintaining contracts
Responsible for applying Hospital privilege for all providers in the practice and working closely with the hospital's credentialing department
Meets with providers to gather, review and provide guidance on completion of credentialing packets. Also, coordinates the accurate input of physician information into CAQH and Medicare, Medicaid and hospital database
Responsible for processing of accurate complementation of Texas Standardized Credentialing Application in MS Word files for each physician
Oversees input of physician documents into database and proper maintenance of Medicare and Medicaid documents
Continuously verify the status of CVs, provider licenses, DEA, DPS certificates and specialty certificates
Continuously track the renewal of provider licenses, DEA, DPS, ACLS certificates
Maintain record keeping on providers' CME and follow up to ensure CME have been completed
Complete various provider applications, and track the status of applications once submitted
Maintain provider files for credentialing purposes
Contact appropriate organizations upon hiring of new providers
Update the appropriate departments on the status of providers credentialing on Managed Care/ Insurances
Medical Billing organization located in West Houston
Recognition, cultivation and rewards for your talent
Opportunities for challenges, learning and advancement with a company aligned with a long term aggressive growth strategy
Opportunity to work directly with the public and your neighboring community
Recognized as more than just a number within a family atmosphere
Opportunity to go straight to the top with an idea, issue or question
Chance to be recognized for individual accomplishments and contributions
Restaurants and shopping nearby
Monday thru Friday 8am to 4: 30 PM
High School Diploma or G.E.D. Required
2+ years of experience with physician and facility credentialing is required
2+ years of experience with in-network contracting with insurance carriers for physician and facilities required
Maintain strong skills in diplomacy, professionalism and trustworthiness
Strong communications skills in both oral and written.
Positive attitude, Team Player, "Go-getter"
Knowledge of CMR, EPower, Practice Fusion, and Centricity desired
Familiarity with computer and Windows PC applications, which includes the ability to learn new computer systems applications
Ability to manage multiple priorities and projects
Detail oriented with desire for producing work with 100% accuracy
Excellent analytical and problem solving skills

Shannon Coleman, CPC
Staffing Consultant

Shannon has lived in Houston for almost twenty years and considers the big city her home. Growing up in Beaumont, Shannon graduated from Lamar University with a degree in Business Administration. After successful careers with Ford Motor Credit and the Houston Chronicle, Shannon joined ExecuTeam in 2015 and earned her CPC (Certified Personnel Consultant) Certification shortly thereafter. In 2016, Shannon transitioned to Team1Medical Staffing specializing in Medical Administrative personnel including Front Office, Billing Specialist and Call Center personnel. Shannon is excited by the challenge of recruiting for a variety of positions and looks forward in assisting with your career search!

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