Credentialing Coordinator II

Job Summary And Responsibilities
Coordinates credentialing activities at the division level; including data entry and physician database maintenance; credentialing processes, expirables and other duties that support provider onboarding activities. Serves as effective liaison between provider and the facilities throughout the credentialing process. Responsible for analyzing and understanding State and Federal Regulatory Agencies requirements, accreditation compliance and other critical matters that affect the healthcare environment as it relates to the credentialing process. Ability to analyze facility-specific Bylaws requirements to assure compliance. Actively collaborates with leadership and mentors less experienced credentialing team members.

Essential Functions

• Initiates and coordinates the collection of primary source information for credentialing purposes at the division level. Verifies, compiles, manages and maintains confidential research required for credentialing of initial appointment and reappointment applicants. Processes applications according to established legal, State and Federal agencies, State licensing board, regulatory and facility standards. Coordinates, tracks, and monitors flow of information to ensure the timely processing and notification of applicants in accordance with the guidelines established.
• Conducts thorough analysis of all primary source documentation received for assessment of qualifications/competencies. Assures appropriate education and training including procedural documentation has been provided to support clinical privileges requested. Identifies any potential quality of care issues, behavioral problems, and/or other issues escalating as necessary. Summarizes and prepares credentialing information, including information about flagged concerns, for review and decisions. Applies the credentials evaluation process uniformly to all initial appointment and reappointment applications to ensure compliance with CHI St. Luke's 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. Support and assist less experienced credentialing team members in a learning environment..
• Facilitates review, assessment and authenticated documentation of an evaluation of each application. Serves as the primary point of contact for practitioners during appointment and reappointment process. Must be available to guide practitioners through the process and clearly communicate requirements. Assist less experienced credentialing team members with preparing communication to practitioners in complex situations.
• Maintains an accurate, secure and current database of physician and advanced practitioner/allied health professional information. Proficient with MSOW, Cactus or similar credentialing platform. Follows data entry policy. Serves as database "super user" and trainer as required.
• Mentors less experienced colleagues, actively identifies and participates in developing and implementing best practices.
• Appropriately escalates concerns regarding credentialing documents and/or timeliness of the verification process. Communicates with facilities appropriately and in a timely manner according to policy. Maintains confidentiality.
• Support system and division standardization efforts. Actively identifies, participates in developing and implementing best practices.
• Monitors and maintains all required expirables.

Disclosure Summary
The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.
Job Requirements
Education and Experience Required

• Ten (10) years of experience in the medical staff services profession -OR-
• Five (5) years experience with CPCS or PMSVSC
• Preferred: Associates Degree and Credentialing database experience, MSOW or Cactus

Licensure And Certifications Required

• Certified Provider Credentialing Specialist (CPCS) -OR- Prof Medical Services Manager (PMSVSC)

Knowledge, Skills, Abilities, And Training Required

• 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 judgement based on appropriate information.
• Accept and carry out responsibility for direction, control and planning for day-to-day workload.

Where You'll Work
Baylor St. Luke's Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care, neuroscience, oncology, transplantation, and more. Our team's efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere else in the world. In our commitment to advancing standards in an ever-evolving healthcare environment, our new McNair Campus is designed around the human experience—modeled on evidence-based practices for the safety of patients, visitors, staff, and physicians. The 27.5-acre campus represents the future of healthcare through a transformative alliance focused on leading-edge patient care, research, and education. Our strong alliance with Texas Heart Institute and Baylor College of Medicine allows us to bring our patients a powerful network of care unlike any other. Our collaboration is focused on increasing access to care through a growing network of leading specialists and revolutionizing healthcare to save lives and improve the health of the communities we serve.

Pay Range
$ $34.12 /hour