Job Details

Description

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

* 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 HoursWork Type:

Full Time