Credentialing Specialist

1 week ago


Fort Worth, Texas, United States Cook Children's Health Care System Full time
Credentialing and Accreditation Coordinator Job Description

Job Summary: We are seeking a highly organized and detail-oriented Credentialing and Accreditation Coordinator to join our team at Cook Children's Health Care System.

Key Responsibilities:

  • Coordinate and facilitate the credentialing and recredentialing process for Cook Children's Healthcare System, ensuring compliance with regulatory requirements and accreditation standards.
  • Communicate effectively with insurance organizations, managed care organizations, healthcare delivery systems, regulatory organizations, and providers to ensure seamless credentialing and accreditation processes.
  • Handle confidential information from various sources, including providers, national databases, and regulatory organizations.
  • Collaborate with internal stakeholders to ensure accurate and timely credentialing and accreditation documentation.
  • Stay up-to-date with industry developments, regulatory changes, and accreditation standards to ensure compliance and quality improvement.

Requirements:

  • High school diploma or equivalent required; some college education preferred.
  • 3-5 years of experience working with hospital and/or managed care products and programs.
  • Experience with credentialing, audit, and accreditation processes, including NCQA and Joint Commission standards and guidelines.
  • Certification/Licensure: 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 dedicated to providing exceptional care to children and adolescents. We offer a unique approach to healthcare, with a focus on collaboration and communication among our teams to deliver high-quality patient care.



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