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 preferred
-
High School Diploma or equivalent required
Experience
- Minimum of 3 years of relevant credentialing experience preferred
Licenses, Registrations, or Certifications
- Certified Provider Credentialing Specialist (CPCS) preferred
Work Schedule:
8AM - 5PM Monday-Friday
Work Type:
Full Time
