Credentialing Coordinator II

1 week ago

Houston Texas, United States CommonSpirit Health Full time
About the Role

We are seeking a highly skilled and experienced Credentialing Coordinator II to join our team at CommonSpirit Health. As a key member of our medical staff services team, you will play a critical role in ensuring the timely and accurate credentialing of healthcare providers.

Key Responsibilities
  • Coordinate credentialing activities at the division level, including data entry and physician database maintenance.
  • Serve as a liaison between providers and facilities throughout the credentialing process.
  • Analyze and understand State and Federal Regulatory Agencies requirements, accreditation compliance, and other critical matters that affect the healthcare environment.
  • Collaborate with leadership and mentor less experienced credentialing team members.
  • Initiate and coordinate the collection of primary source information for credentialing purposes.
  • Verify, compile, manage, and maintain confidential research required for credentialing of initial appointment and reappointment applicants.
  • Process applications according to established legal, State and Federal agencies, State licensing board, regulatory, and facility standards.
  • Conduct thorough analysis of all primary source documentation received for assessment of qualifications/competencies.
  • Assure appropriate education and training, including procedural documentation, has been provided to support clinical privileges requested.
  • Identify any potential quality of care issues, behavioral problems, and/or other issues escalating as necessary.
  • Summarize and prepare credentialing information, including information about flagged concerns, for review and decisions.
  • Apply the credentials evaluation process uniformly to all initial appointment and reappointment applications to ensure compliance with CommonSpirit Health credentialing policies, procedures, and applicable Medical Staff Bylaws.
  • Compile information regarding CME credits and other requirements in accordance with state licensing requirements and Division policy.
  • Maintain an accurate, secure, and current database of physician and advanced practitioner/allied health professional information.
  • Proficient with MSOW, Cactus, or similar credentialing platform.
  • Mentor less experienced colleagues and actively identify and participate in developing and implementing best practices.
Requirements
  • Ten (10) years of experience in the medical staff services profession OR Five (5) years experience with Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) certification.
  • Associate's degree preferred.
  • Minimum knowledge, skills, and abilities:
    • Credentialing database experience, MSOW or Cactus preferred.
    • Proficiency in Microsoft Office and/or Google Workspace.
    • Excellent written and oral communication skills.
    • Excellent data entry skills; detail-oriented, ability to prioritize tasks.
    • Ability to work remotely as necessary while maintaining confidentiality, communicating appropriately, and completing assignments according to deadlines.
    • Ability to comprehend and follow instructions; maintain attention and concentration for necessary periods.
    • Ability to synthesize, coordinate, and analyze data, perform simple and repetitive tasks, and maintain a work pace appropriate to given workload.
    • Perform complex and varied tasks; relate to other people beyond giving and receiving instructions in stressful situations, get along well with customers, co-workers, and peers.
    • Understand the meaning of words and how to use them appropriately and effectively; make appropriate independent decisions and/or exercise judgment based on appropriate information.
    • Accept and carry out responsibility for direction, control, and planning for day-to-day workload.

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