Clark, New Jersey
Miami, Florida
Pompton Plains, New Jersey
Posted: 07-Feb-25
Location: Irving, Texas
Categories:
Internal Number: 249807
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 Type:
Full Time
EEO is the law - click below for more information:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
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