Director of Credentialing and Payer Enrollment (4087)
Waco, Texas, United States
OnsiteFull Time
Waco Family Medicine: Community health center providing primary care and medical education.
2+ YOEOversee credentialing, privileging, and payer enrollment for clinical sites and staff; supervise C&P and enrollment teams; use VerityStream and EHR systems; ensure compliance with HRSA, CMS, Medicaid and commercial payer rules.
Allegiance Mobile Health: Provides emergency medical services and ambulance transport.
0.75+ YOEVerify patient and payer eligibility for ground ambulance transports (Medicare/Medicaid/commercial), document results in LOGIS, and communicate with payers, dispatch, and patients; high attention to detail and data entry accuracy required.
Maryland Oncology Hematology: Provider of community-based medical oncology and hematology care.
3+ YOE3+ years medical insurance verification/authorization and 2 years clinical review for senior level; high school required, associates or LPN preferred; knowledge of payer guidelines and clinical pathway review.
6+ YOEBachelor's degree required; 6+ years sales experience engaging HCPs in commercial life sciences; experience with payers/health systems; coaching and cross-functional collaboration; ability to manage access, reimbursement, and compliance.
Georgetown Behavioral Health Institute: Provides comprehensive inpatient and outpatient acute psychiatric hospital services.
3+ YOEHigh school diploma required (BA preferred). 3+ years admitting/financial counseling preferred. Must have PC skills including Windows, Microsoft Outlook/Word/Excel, knowledge of payer requirements, HIPAA confidentiality, and pass background/drug/physical screens.
Windows Operating System, Microsoft Outlook, Microsoft Word, Microsoft Excel