Credentialing & Payer Enrollment Specialist

CommonSpirit HealthHouston, TX
9d

About The Position

Where You’ll Work Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area. Job Summary and Responsibilities Verifies the credentials of physician and allied health professional applicants and re‐applicants, and Prepares the candidates for review by the appropriate clinical Service Chief and Medical Staff Committees. Manage the process of sending initial and/or reappointment applications and monitoring their return with required documents Responsible for processing appointment/reappointment applications in an accurate, thorough, and timely manner; clearly and succinctly communicate reappointment status to applicant in writing File appointment/reappointment applications and other communication as needed Prepare files other documents, as requested, for review and evaluation of the clinical Service Chief and Credentials Committee in an accurate, consistent, professional, and organized manner Perform 3rd party verifications of submitted material as required by department policy, medical staff policy, and the Bylaws of the Medical Staff Document receipt of application materials and verifications in the credentialing system (ECHO) (e.g. Texas Medical License, Malpractice Insurance, DEA, Board Certification, DPS, etc.). File copy in physician's file Ensure all credentialing‐related information is accurate and up to date in the ECHO system and in the applicant files With the assistance of the Supervisor, utilize Echo to run reports and make certain all certifications and other tracked information as required is up to date and accurate

Requirements

  • High School Diploma/GED required

Responsibilities

  • Verifies the credentials of physician and allied health professional applicants and re‐applicants, and Prepares the candidates for review by the appropriate clinical Service Chief and Medical Staff Committees.
  • Manage the process of sending initial and/or reappointment applications and monitoring their return with required documents
  • Responsible for processing appointment/reappointment applications in an accurate, thorough, and timely manner; clearly and succinctly communicate reappointment status to applicant in writing
  • File appointment/reappointment applications and other communication as needed
  • Prepare files other documents, as requested, for review and evaluation of the clinical Service Chief and Credentials Committee in an accurate, consistent, professional, and organized manner
  • Perform 3rd party verifications of submitted material as required by department policy, medical staff policy, and the Bylaws of the Medical Staff
  • Document receipt of application materials and verifications in the credentialing system (ECHO) (e.g. Texas Medical License, Malpractice Insurance, DEA, Board Certification, DPS, etc.). File copy in physician's file
  • Ensure all credentialing‐related information is accurate and up to date in the ECHO system and in the applicant files
  • With the assistance of the Supervisor, utilize Echo to run reports and make certain all certifications and other tracked information as required is up to date and accurate

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

5,001-10,000 employees

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