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 experienceExperience
Minimum of at least 3 years of experience related to hospital or managed care credentialing.Licenses, Registrations, or Certifications
Certified Provider Credentialing Specialist (CPCS) preferredWork Schedule :
8AM - 5PM Monday-Friday
Work Type : Full Time