Memorial Hermann Health System
Credentialing Specialist
Memorial Hermann Health System, Houston, Texas, United States, 77246
Join us as a Credentialing Specialist at Memorial Hermann Health System.
Job Summary Under general supervision, the Credentialing Specialist will be responsible for conducting activities related to initial credentialing, re-credentialing, delegation, facility credentialing, and ongoing provider file maintenance, typically reporting to the Credentialing Manager.
Responsibilities
Process provider applications and re-applications including initial mailing, review, and loading; coordinate the distribution of emails, mail‑outs, or other documents to customers.
Assist in the implementation of procedures and activities related to the credentialing, re-credentialing, and privileging of network providers.
Maintain the provider profiling system and communicate with providers by phone and mail regarding credentialing status.
Track, maintain, and update licensure: DEA and state narcotics certification or other expiring credentials; coordinate with physician office to obtain expiring documents.
Answer internal and external customer phone calls; provide physicians with credentialing application status updates in a timely and professional manner; elevate concerns appropriately.
Monitor physician sanction sources and board actions, escalating alerts as needed.
Perform basic data entry on credentialing applications.
Ensure safe care to patients, staff, and visitors; adhere to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service.
Promote individual professional growth and development by meeting requirements for mandatory/continuing education and skill competency; support department-based goals; serve as preceptor, mentor and resource to less experienced staff.
Model Memorial Hermann’s service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues.
Other duties as assigned.
Minimum Qualifications
Associate’s degree preferred.
One (1) year of credentialing experience in a managed care plan, medical staff services, or credentialing verification office.
Effective analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
Effective oral and written communication skills.
Basic computer skills (Microsoft Office, Word, Excel).
Basic understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
Demonstrated ability to work independently and collaboratively with a team and multiple departments, taking full responsibility for tasks.
#J-18808-Ljbffr
Job Summary Under general supervision, the Credentialing Specialist will be responsible for conducting activities related to initial credentialing, re-credentialing, delegation, facility credentialing, and ongoing provider file maintenance, typically reporting to the Credentialing Manager.
Responsibilities
Process provider applications and re-applications including initial mailing, review, and loading; coordinate the distribution of emails, mail‑outs, or other documents to customers.
Assist in the implementation of procedures and activities related to the credentialing, re-credentialing, and privileging of network providers.
Maintain the provider profiling system and communicate with providers by phone and mail regarding credentialing status.
Track, maintain, and update licensure: DEA and state narcotics certification or other expiring credentials; coordinate with physician office to obtain expiring documents.
Answer internal and external customer phone calls; provide physicians with credentialing application status updates in a timely and professional manner; elevate concerns appropriately.
Monitor physician sanction sources and board actions, escalating alerts as needed.
Perform basic data entry on credentialing applications.
Ensure safe care to patients, staff, and visitors; adhere to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service.
Promote individual professional growth and development by meeting requirements for mandatory/continuing education and skill competency; support department-based goals; serve as preceptor, mentor and resource to less experienced staff.
Model Memorial Hermann’s service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues.
Other duties as assigned.
Minimum Qualifications
Associate’s degree preferred.
One (1) year of credentialing experience in a managed care plan, medical staff services, or credentialing verification office.
Effective analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
Effective oral and written communication skills.
Basic computer skills (Microsoft Office, Word, Excel).
Basic understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
Demonstrated ability to work independently and collaboratively with a team and multiple departments, taking full responsibility for tasks.
#J-18808-Ljbffr