Licensing & Credentialing - Healthcare Providers

**This position is On-Site at the Plano, TX Headquarters**

QUALIFICATIONS AND EDUCATION REQUIREMENTS

• 2 years of work experience in a clinical and/or compliance setting with knowledge of Licensing, Medicare, Medicaid, Research Skills, Reporting Research Results
• High School Diploma; college degree preferred
• Understanding of healthcare regulations including Fraud, Abuse and Anti-Kickback.
• Federal and State credentialing experience
• Advanced proficiency in Microsoft Office, Excel, Word, and Teams.
• Detail oriented and critical thinking skills
• Good organization, people and problem-solving skills and the ability to simultaneously multi-task many projects and strategies.
• Ability to meet critical deadlines.

ESSENTIAL DUTIES:

• Prepare all Licensing documents to include initial, renewal and location change applications for submission to corresponding State agency
• Prepare additional renewals and changes to include CHAPS, NHPCO, TNMHO, IAHHC, IHPCO, CLIA, ISDH, HHSC, LARA, NGS, PGBA
• Process any personnel changes that are required to be reported to corresponding State Agency. This also includes physical location, phone and fax number updates
• Complies with federal, state, and local legal requirements by studying existing and new legislation; enforcing adherence to requirements; advising management on needed actions
• Acts as a resource to field agencies in compliance and licensing issues. Provides administrative support to the legal department objectives
• CHAP – update CHAP and submit for survey readiness
• Review and support Medicaid contract renewals, revalidations, and ongoing maintenance, including updating portals such as TMHP, PEMS, and CAMP with designation changes, relocations, and other updates. Ensure information in TULIP, PECOS, and CAMP is accurate and consistent across all systems
• Coordinate with the company’s insurance provider to maintain accurate records of company agencies, including adding, updating, or removing locations, and ensure updated Certificates of Insurance (COIs) are obtained and uploaded to the company’s document management system
• Support new acquisitions by sending timely Letters of Intent to Medicare and Medicaid, adding new locations to state and federal portals, and submitting required change-of-information applications
• Timely submission of all documentation

• Performance of other duties as required
• Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures