Academy of Managed Care Pharmacy
Coordinator Credentialing CVO - Staff Credentialing
Academy of Managed Care Pharmacy, Irving, Texas, United States, 75084
Description
Summary: Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process within the CVO. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. Responsible for the accuracy and integrity and developing a credentialing database.
Responsibilities
Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
Conducts thorough investigation, research, and primary source verification of all components of the application file.
Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up.
Reviews necessary documentation and verifications prior to submittal to clients, ensuring turnaround time and quality of data is within required metrics.
Responds to inquiries from other healthcare organizations, interfaces with internal/ external customers on day-to-day credentialing/privileging issues as they arise.
Meets weekly performance metrics which includes: file completion, quality, and turnaround time.
Utilizes and maintains the credentialing database, optimizing efficiency, and performs queries, reports, and document generation.
Maintains strict confidentiality of all data and information.
Performs miscellaneous job-related duties as assigned.
Job Requirements Education/Skills
Bachelor’s Degree or equivalent job-related experience
Experience
Minimum of at least 3 years of experience related to hospital or managed care credentialing.
Licenses, Registrations, or Certifications
Certified Provider Credentialing Specialist (CPCS) preferred
Work Schedule: 8AM - 5PM Monday-Friday
Work Type: Full Time
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Responsibilities
Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Coordinates and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility.
Conducts thorough investigation, research, and primary source verification of all components of the application file.
Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up.
Reviews necessary documentation and verifications prior to submittal to clients, ensuring turnaround time and quality of data is within required metrics.
Responds to inquiries from other healthcare organizations, interfaces with internal/ external customers on day-to-day credentialing/privileging issues as they arise.
Meets weekly performance metrics which includes: file completion, quality, and turnaround time.
Utilizes and maintains the credentialing database, optimizing efficiency, and performs queries, reports, and document generation.
Maintains strict confidentiality of all data and information.
Performs miscellaneous job-related duties as assigned.
Job Requirements Education/Skills
Bachelor’s Degree or equivalent job-related experience
Experience
Minimum of at least 3 years of experience related to hospital or managed care credentialing.
Licenses, Registrations, or Certifications
Certified Provider Credentialing Specialist (CPCS) preferred
Work Schedule: 8AM - 5PM Monday-Friday
Work Type: Full Time
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