Major/Essential Functions
Initiates enrollment for Medicare and Medicaid
Initiates enrollment for MCOs
Responds to miscellaneous requests from providers, administrators and or other facilities
Maintains and updates credentialing expirables and preforms PSV.
Processes recredentialing to the MCOs
Manage and maintain status of all enrollment applications to include but not limited to submission date, contact date, follow up date, etc.
Other duties as assigned.
Processes PLFSOM, hospital and other facilities initial applications and re-appointments to include but not limited to TSCA application, TTUSHC supplementary form, Delineation of Privileges and other required documents to ensure accreditation.
Required Qualifications
High school diploma
Plus six years experience in related field.
Additional education may substitute for experience on a year for year basis.
Preferred Qualifications
Knowledge of Cactus Credentialing Software.
Knowledge of The Joint Commission’s Standards as they relate to Credentialing and Privileging.
Knowledge of NCQA standards as it relates to credentialing and health plan enrollment.
Knowledge of medical terminology as it relates to specific privileges.
CPCS certification preferred.
Provider Enrollment and Provider Credentialing experience.
EEO Statement
As an EEO/AA employer, the Texas Tech University System and its components will not discriminate in our employment practices based on an applicant’s race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information or status as a protected veteran.
Jeanne Clery Act
The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. You can locate this report through our website at: https://www.ttuhsc.edu/emergency/clery-report.aspx.
Does this position work in a research laboratory?
No
Required Attachments
Cover Letter, Resume / CV
Job Type
Full Time
Pay Basis
Hourly
Minimum Hire Rate
Compensation is commensurate upon the qualifications
Pay Statement
Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as, the institutional pay plan. For additional information, please reference the institutional pay plan on the Human Resources webpage.
Travel Required
Up to 25%
Shift
Day
Schedule Details
M – F , 8 am to 5 pm
Grant Funded?
No
Job Group
Office and Admn Wkrs All Other
Job Expires
08/18/2022
Source: Indeed.com
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