Provider Services Specialist- Credentialing & Provider Enrollment at UTHealth

Posted in General Business 6 days ago.

Type: Full-Time
Location: Houston, Texas





Job Description:

Position Summary:

Coordinates, monitors and completes the enrollment process for all providers.

Position Key Accountabilities:

1. Responsible for submitting license updates to Medicare and Medicaid. Processes licensure list from UT System for update.

2. Processes Blue Cross and Blue Shield and Railroad Medicare applications.

3. Prepares worksheets for Medicaid submission.

4. Assists with preparation for monthly credentialing meeting.

5. Assists with preparing the Medicare Opt-Out Listing.

6. Runs reports as needed and assists in preparation for audits.

7. Prepares files and processes applications for initial and recredentialing, including data entry into systems for all departments. Updates licensure on all providers in the system.

8. Regularly communicates information on expired licensure to all departments.

9. Performs other duties as assigned.

Certification/Skills:

Experience with Microsoft Office (including Outlook, Word, Excel, and PowerPoint), databases, internet, phone systems.

Minimum Education:

High School Diploma or equivalent.

Minimum Experience:

None. May substitute required experience with equivalent years of education beyond the minimum education requirement.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

Residency Requirement:

Employees must permanently reside and work in the State of Texas.





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