Job Details

DescriptionSummary:

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

Bachelor's 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