Position Summary:

Manages the facility credentialing and enrollment process by coordinating, monitoring, and ensuring completion of the credentialing and enrollment process.

Location: Dunn Behavioral Sciences Center/HCPC at UTHealth Houston

Dept.: BSC Patient Revenue Cycle

Status: Full-Time

FLSA: Exempt

Position Key Accountabilities:

Essential Functions

• Manages facility credentialing, recredentialing, and enrollment.
• Oversees completion of managed care provider enrollment applications (new, changes, revalidations) for nurse practitioners.
• Maintains database with provider, payer, per diem rates, rate negotiation dates, and ensures correct rates are updated in Epic.
• TMHP (Medicaid) Administrator: adds new users, links existing users; updates facility information.
• Responsible for EDI enrollment for claims, EFT and ERA for insurance carriers.
• Acts as resource contact for billing services regarding billing and denial issues with the payer relations representatives.
• Manages Human Resources activities of department in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning.
• Performs other duties as assigned.

Certification/Skills:

Strong analytical thinking, problem solving skills and communications skills with attention to detail.

Proficiency in using Microsoft Office (including Word, Excel, PowerPoint, and Access).

Minimum Education:

Bachelor's Degree in Business, Healthcare Administration, Health Information Management or related field required. May substitute required education with equivalent years of experience beyond the minimum experience requirement.

Minimum Experience:

5 years in directly related area required

Physical Requirements:

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

Security Sensitive:

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.