The University of Texas at Austin
Payer Credentialing Specialist
at
The University of Texas at Austin
Location:
Austin, TX
Overview The Payer Credentialing Specialist is responsible for managing the credentialing and re-credentialing processes for healthcare providers with various insurance payers. This role ensures that all provider credentials are accurate, up-to-date, and compliant with regulatory standards.
Responsibilities
Manage the initial credentialing and re-credentialing processes for healthcare providers.
Verify provider credentials, including education, licensure, and certifications.
Ensure compliance with payer requirements and regulatory standards.
Submit and track provider enrollment applications with insurance payers.
Follow up with payers to resolve any issues or delays in the enrollment process.
Maintain accurate records of enrollment status and documentation.
Maintain and update credentialing databases and provider files.
Generate reports on credentialing status and compliance metrics.
Ensure data accuracy and integrity in all credentialing records.
Communicate with providers, payers, and internal departments to facilitate the credentialing process.
Address and resolve any credentialing-related inquiries or issues.
Provide regular updates to stakeholders on credentialing status.
Conduct audits with payers as per delegated credentialing agreements and implement corrective action plans as needed.
Ensure compliance with all regulatory and accreditation requirements.
Participate in audits and quality assurance activities.
Implement process improvements to enhance credentialing efficiency and accuracy.
Qualifications Required Qualifications
High School Diploma/GED
At least 2 years of experience in healthcare credentialing or provider enrollment.
Preferred Qualifications
Associate's Degree in healthcare administration or related field.
At least 4 years of experience in payer credentialing or medical staff services.
Certified Provider Credentialing Specialist (CPCS) from NAMSS.
Salary $50,000 + depending on qualifications.
Legal The University of Texas at Austin, as an equal opportunity/affirmative action employer, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, or veteran status in employment, educational programs and activities, and admissions.
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at
The University of Texas at Austin
Location:
Austin, TX
Overview The Payer Credentialing Specialist is responsible for managing the credentialing and re-credentialing processes for healthcare providers with various insurance payers. This role ensures that all provider credentials are accurate, up-to-date, and compliant with regulatory standards.
Responsibilities
Manage the initial credentialing and re-credentialing processes for healthcare providers.
Verify provider credentials, including education, licensure, and certifications.
Ensure compliance with payer requirements and regulatory standards.
Submit and track provider enrollment applications with insurance payers.
Follow up with payers to resolve any issues or delays in the enrollment process.
Maintain accurate records of enrollment status and documentation.
Maintain and update credentialing databases and provider files.
Generate reports on credentialing status and compliance metrics.
Ensure data accuracy and integrity in all credentialing records.
Communicate with providers, payers, and internal departments to facilitate the credentialing process.
Address and resolve any credentialing-related inquiries or issues.
Provide regular updates to stakeholders on credentialing status.
Conduct audits with payers as per delegated credentialing agreements and implement corrective action plans as needed.
Ensure compliance with all regulatory and accreditation requirements.
Participate in audits and quality assurance activities.
Implement process improvements to enhance credentialing efficiency and accuracy.
Qualifications Required Qualifications
High School Diploma/GED
At least 2 years of experience in healthcare credentialing or provider enrollment.
Preferred Qualifications
Associate's Degree in healthcare administration or related field.
At least 4 years of experience in payer credentialing or medical staff services.
Certified Provider Credentialing Specialist (CPCS) from NAMSS.
Salary $50,000 + depending on qualifications.
Legal The University of Texas at Austin, as an equal opportunity/affirmative action employer, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, or veteran status in employment, educational programs and activities, and admissions.
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