Tenet Healthcare seeks an experienced provider enrollment credentialing specialist, with knowledge of government payers (Medicare/Medicaid) enrollment. Office location is Frisco on Toll Road
ï¿½Candidates should have knowledge of NCQA standards, delegated credentialing and Primary Source Verification.
ï¿½Candidates should have knowledge of health plan credentialing and enrollment including Medicare and Medicaid.
ï¿½Ability to prepare and/or update the providerï¿½s CAQH application for newly affiliated and existing healthcare providers for initial and recredentialing activity.
ï¿½The ability to build and maintain peer-to-peer relationships with all relevant market and national health plans.
ï¿½Establish credentialed status to facilitate billing for multiple specialties.
ï¿½Maintain and update credentialing databases completely and accurately and ensures up-to-date tracking of file process.
ï¿½In-depth working knowledge of the various applications associated by plan as well as internally and the workflow process defined by department leadership.
ï¿½Ensure all workflow items are completed within the set turn-around-times, meeting quality expectations.
ï¿½Minimum of two years of experience in a credentialing role or related health care environment, such as credentialing or file maintenance preferred.
ï¿½Understanding of Medicare and Medicaid enrollment (multiple states) as well as experience in navigating government portals preferred.
ï¿½Knowledge of health plan credentialing, enrollment and requirements .
ï¿½Knowledge of CAQH.
ï¿½Baseline knowledge of revenue cycle.
ï¿½Ability to work within a deadline-intense environment.
ï¿½Demonstrated problem-solving and customer service skills.
ï¿½Knowledge of Microsoft Word and other PC applications.
ï¿½High School Diploma or equivalent required; completion of an applicable Vocational or Technical training program preferred.
ï¿½Excellent verbal and written communication skills.
Primary Location: Plano, Texas
Facility: Tenet Physician Resources
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005000007
About Tenet Physician Resources
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.