Credentialing Coordinator

2 weeks ago

Katy, Texas, United States UTHealth Full time
Job Summary

This position is responsible for supporting and coordinating all provider and physician credentialing activities. The Credentialing Coordinator verifies that all policies and procedures associated with credentialing meet external accreditation, state regulatory requirements, and organizational requirements.

Key Responsibilities
  • Conducts credentialing and re-credentialing related activities.
  • Monitors and maintains credentialing databases and files for practitioners and providers.
  • Facilitates applications and re-applications for providers per company and state requirements.
  • Communicates with providers in a timely manner regarding status of credentialing via written or verbal communication.
  • Maintains additions, changes, and terminations in credentialing database.
  • May facilitate new provider orientation and onboarding.
  • May manage policies and procedures associated with provider credentialing.
  • Conducts credentialing audits and satisfaction surveys.
  • Effectively communicates with all stakeholders.
  • Continuous compliance with HIPAA regulations and Compliance/Program Integrity requirements.
Requirements
  • Certified Professional Credentialing Specialist (CPCS) preferred.
  • Current and thorough knowledge of all rules, laws, regulations, accreditation requirements and standards relevant to credentialing. Knowledgeable of NCQA, URAC, and Joint Commission standards and requirements of accreditation.
  • Proficiency (intermediate) with MS Office software, Word, Excel.
  • Demonstrated effective written and oral communication skills.
Education and Experience
  • Associates Degree in related field or equivalent experience in lieu of degree.
  • Three (3) years of credentialing, database management, or medical staff coordination in managed care environment.
Work Environment

This position is located in the Texas Medical Center-Houston, Texas area. The University of Texas Health Science Center at Houston (UTHealth) is a comprehensive academic health center in the UT System and the U.S. Gulf Coast region.

About UTHealth

UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. We offer a comprehensive and competitive benefits package, including 100% paid medical premiums for our full-time employees, generous time off, and a retirement/pension plan.

Equal Employment Opportunity

UTHealth Houston is committed to providing equal opportunity in all employment-related activities without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, genetic information, gender identity or expression, veteran status or any other basis prohibited by law or university policy.

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