Lead Specialist
Texas Tech University - El Paso, TX

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Performs advanced, specialized work to assist in the organization and implementation of various projects and programs. Work is performed under minimal supervision within established policies with latitude for independent judgment. Works on special projects as assigned. May substitute for supervisor during his/her absence.

Major/Essential Functions

Provides applicants a credentialing application and answers questions on the process and required documents. Reviews applications for completeness and verifies information through Primary Sources Verification. Follows up on delinquent information and works aggressively to complete verifications within allowable timeframe.

Initiates request for applications on behalf of the provider for privileges at area hospitals and facilities. Processes re-credentialing applications for hospitals that the provider holds privileges.

Enrolls provider into Medicare, Medicaid, Managed Care and commercial health plans. Follows up on enrollment status and obtain effective enrollment dates. Processes re-credentialing and re-attestations for health plans.

Responsible for establishing and maintaining delegated credentialing functions for contracted payors. Performs audits as required to meet payor requirements

Occasional Duties

Prepares files for Credentialing Committee.

Qualifications

High school plus six years experience in related field. Additional education may substitute for experience on a year for year basis.

Preferred Qualifications

Two years experience credentialing in an abmbulatory healthcare setting, medical staff office or managed care setting. Experience in performing primary source verifications, detailed review and credentials and applications. Previous experience using Cactus software or similar database for credentialing and enrollment.

Knowledge in The Joint Commissions standards as they relate to Credentialing and Privileging.

CPCS certification preferred

Security Sensitive?
Yes

Security Level (TTU only)

Does this position work in a research laboratory?
No

If yes, are select agents used in this laboratory?

Pay Basis
Semi-Monthly (Non-Exempt)

Job Type
Full Time

Campus/Unit
Texas Tech University HSC - El Paso

Work Location
El Paso

Zip Code
79905

Job Open Date
07/24/2013

Job Close Date
08/07/2013

Special Instructions to Applicants

Physical Demands

Estimated amount of on-the-job time spent in the following physical activities:

Stand 2/3

Use hands to finger, handle, feel >2/3

Reach with hands and arms >2/3

Stoop, kneel, crouch, or crawl 2/3

Outdoor weather conditions < 1/3

Amount of weight to be lifted or force required to be exerted and frequency:

Up to 25 pounds < 1/3

Special Vision requirements for this job:
Close vision (clear vision at 20 inches or less)

Work Environment-Amount of noise typical for the work environment of this job:

Moderate Noise (examples: business office with computers and printers, light traffic)

Salary Grade
511

Hourly Pay Range
13.16 - 18.78

Monthly Pay Range
2281.07 - 3255.20

Internal Candidates Only?
No

Internal Cand Open Date

Internal Cand Closing Date

EEO Statement:
The entities of Texas Tech University System are Equal Opportunity employers and are in compliance with Title VII of the Civil Rights Act of 1964 as amended, Texas Commission on Human Rights Act (Texas Labor Code, Chapter 21), Americans with Disabilities Act as amended, and employs without regard to sex, race, color, national origin, religion, age, disability or status as a disabled or Vietnam era veteran.

Quick Link
http://jobs.texastech.edu: 80/postings/55679

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