Performs administrative tasks to ensure provider applications are completed and submitted in a timely manner to participating Managed Care Organizations as part of the Payor Enrollment process.
Completes Government and Commercial Payor Enrollment process on new practitioners within established timeframes
Processes requests, data entry, submissions and file maintenance of enrollment and disenrollment documentation
Ensures and maintains overall accuracy of credentialing and enrollment database
Completes maintenance updates and re-verification/re-validation for all practitioners within established timeframes
Maintains and updates data on practitioners, including, but not limited to: name changes, office location and demographic changes, collaborates or supervises MD updates/changes, links practitioners to new groups, TINs, etc.
Gathers data, builds/runs reports, and sends out updates
Reviews records for completeness and accuracy of required information content and takes appropriate actions to assure enrollments are completed timely
Ensures enrollment files are in order with any issues of concern flagged
Performs additional clerical and/or administrative duties as required
Maintains constant communication with all practitioners and clients
High school diploma or equivalent
Minimum 1 year working with CAQH, Pecos and other enrollment systems ensuring record keeping and/or management is accurate and timely
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.