Memorial Hermann Health System
System Credentialing Coordinator
Memorial Hermann Health System, Houston, Texas, United States, 77246
System Credentialing Coordinator
Position at Memorial Hermann Health System.
Job Summary The Senior Credentialing Specialist is responsible for the coordination of all activities associated with the credentialing and re‑credentialing of physicians and providers. The role ensures that credentialing policies and procedures meet all organizational, state regulatory, and external accreditation requirements. This position reports to the Manager of Credentialing.
Principal Accountabilities
Implement and monitor procedures and activities related to the credentialing, re‑credentialing and privileging of network providers.
Process provider applications and re‑applications, including initial mailing, review, and loading of the database to ensure high quality standards.
Lead training initiatives for less experienced specialists, proctor credentialing exams, and conduct regular file audits.
Maintain provider profiling system and communicate with providers by phone and mail regarding credentialing status.
Provide guidance or expertise to less experienced specialists.
Serve as a liaison during the credentialing processes, communicating with providers in a timely manner.
Assist in managing policies and procedures related to credentialing and provider delegation maintenance.
Ensure safe care for patients, staff and visitors while adhering to all Memorial Hermann policies, procedures, and standards within budgetary specifications.
Promote professional growth by meeting mandatory/continuing education and competency requirements.
Demonstrate commitment to caring for every member of the community through compassionate and personalized experiences.
Perform other duties as assigned.
Minimum Qualifications
Associate's degree preferred.
Three (3) years of credentialing experience in a managed care plan, Medical Staff Services, or credentialing verification office.
Strong analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
Effective oral and written communication skills.
Basic computer skills: Microsoft Office, Word and Excel.
Proficient understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
Demonstrated understanding of initial credentialing and re‑credentialing practices for medical professionals, including primary source verification methods and compliance monitoring.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Health Care Provider
Industries Hospitals and Health Care
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Job Summary The Senior Credentialing Specialist is responsible for the coordination of all activities associated with the credentialing and re‑credentialing of physicians and providers. The role ensures that credentialing policies and procedures meet all organizational, state regulatory, and external accreditation requirements. This position reports to the Manager of Credentialing.
Principal Accountabilities
Implement and monitor procedures and activities related to the credentialing, re‑credentialing and privileging of network providers.
Process provider applications and re‑applications, including initial mailing, review, and loading of the database to ensure high quality standards.
Lead training initiatives for less experienced specialists, proctor credentialing exams, and conduct regular file audits.
Maintain provider profiling system and communicate with providers by phone and mail regarding credentialing status.
Provide guidance or expertise to less experienced specialists.
Serve as a liaison during the credentialing processes, communicating with providers in a timely manner.
Assist in managing policies and procedures related to credentialing and provider delegation maintenance.
Ensure safe care for patients, staff and visitors while adhering to all Memorial Hermann policies, procedures, and standards within budgetary specifications.
Promote professional growth by meeting mandatory/continuing education and competency requirements.
Demonstrate commitment to caring for every member of the community through compassionate and personalized experiences.
Perform other duties as assigned.
Minimum Qualifications
Associate's degree preferred.
Three (3) years of credentialing experience in a managed care plan, Medical Staff Services, or credentialing verification office.
Strong analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
Effective oral and written communication skills.
Basic computer skills: Microsoft Office, Word and Excel.
Proficient understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
Demonstrated understanding of initial credentialing and re‑credentialing practices for medical professionals, including primary source verification methods and compliance monitoring.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Health Care Provider
Industries Hospitals and Health Care
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