Job Details

Summary:

Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process within the CVO. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity and developing a credentialing database.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
• Conducts thorough investigation, research, and primary source verification of all components of the application file.
• Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up.
• Reviews necessary documentation and verifications prior to submittal to clients, ensuring turnaround time and quality of data is within required metrics.
• Responds to inquiries from other healthcare organizations, interfaces with internal/ external customers on day-to-day credentialing/privileging issues as they arise.
• Meets weekly performance metrics which includes: file completion, quality, and turnaround time.
• Utilizes and maintains the credentialing database, optimizing efficiency, and performs queries, reports, and document generation.
• Maintains strict confidentiality of all data and information.
• Performs miscellaneous job-related duties as assigned.

Job Requirements:

Education/Skills

• Bachelors Degree or equivalent job-related experience

Experience

• Minimum of at least 3 years of experience related to hospital or managed care credentialing.

Licenses, Registrations, or Certifications

• Certified Provider Credentialing Specialist (CPCS) preferred

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time

Job Industries

• Other