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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 within the credentialing database.

MAJOR RESPONSIBILITIES 

• Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. 
• Conducts thorough investigation, research, and timely 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. 
• Utilizes and maintains the credentialing database, optimizing efficiency, and performs queries, reports, and document generation. 
• Meets weekly performance metrics which includes:  file completion, quality, and turnaround time.   
• Trains new associates on job responsibilities, and provides further re-education. 
• Leads projects assigned by management. 
• Maintains strict confidentiality of all data and information. 
• Performs miscellaneous job-related duties as assigned. 

POSITION QUALIFICATIONS 

• Bachelor's Degree or equivalent job-related experience 
• Minimum of at least five (5) years' experience related to hospital or managed care credentialing. 
• Certified Provider Credentialing Specialist (CPCS) preferred. 

Work Type: 

Full Time

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About CHRISTUS Health

CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.

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