Credentialing Specialist
4 weeks ago
At Cook Children's Health Care System, we are seeking a highly skilled Credentialing and Accreditation Specialist to join our team. As a key member of our credentialing team, you will be responsible for coordinating and facilitating the credentialing/recredentialing process for our healthcare system. This includes communication with insurance organizations, managed care organizations, healthcare delivery systems, regulatory organizations, and providers. You will handle sensitive information from various sources in a highly confidential manner, including providers, national databases, and regulatory organizations.
Key Responsibilities:
- Coordinate and facilitate the credentialing/recredentialing process for Cook Children's Health Care System.
- Communicate with insurance organizations, managed care organizations, healthcare delivery systems, regulatory organizations, and providers.
- Handle sensitive information from various sources in a highly confidential manner.
Requirements:
- High school or equivalent required; some college preferred.
- 3-5 years experience working with hospital and/or managed care products and programs.
- Includes experience with the credentialing process, audit process, and NCQA and Joint Commission Standards and Guidelines, as well as other external accreditation standards.
Certification/Licensure:
- Require CPCS or CPMSM Certification or ability to be certified within four years of employment.
About Us:
Cook Children's Health Care System is a leading integrated pediatric healthcare delivery organization. We offer a unique approach to caring for children because we are one of the country's leading integrated pediatric healthcare delivery organizations. Patients benefit from the integrated system because it allows Cook Children's to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
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