Credentialing Specialist
1 week ago
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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