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Coordinator Credentialing CVO - Staff Credentialing (Irving)

Coordinator Credentialing CVO - Staff Credentialing (Irving)

Christus HealthIrving, TX, United States
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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

  • 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 :

    8AM - 5PM Monday-Friday

    Work Type : Full Time

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    Credentialing Coordinator • Irving, TX, United States

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