Career opportunities at Methodist Health System
- Job Title
- CREDENTIALING COORDINATOR
- Job ID
- Dallas, TX 75203
- Other Location
CREDENTIALING COORDINATOR FEATURED
METHODIST HEALTH SYSTEM
DALLAS, TX, 75265-5999
Full-time · Day · 8 am - 5 pm
Req # 20057640
The Credentialing Coordinator Utilizes knowledge of credentialing/re-credentialing principles, NCQA Standards, legal principles of credentialing, credentialing and managed care terminology, and management of credentialing information in the review of practitioners credentialing/re-credentialing applications. Utilizes computer and data organizational skills to support the credentialing functions of DMPN and to populate and maintain the DMPN credentialing. Responsible for data integrity, accuracy, and consistency of practitioners' information in DMPN's database.
Your Job Requirements:
- Some college or college degree preferred but not required.
- Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) preferred but not required.
- Experience in using Windows and various software applications including databases, Excel spreadsheets, and graphics.
- Intermediate to advanced level of proficiency in computer skills using Microsoft Office.
- Experience in scanning documents into a personal computer. Multitasking skills.
- Work Experience: 3-4 years experience
- Responsible for tracking and obtaining current expiable for practitioners.
- Responsible for Medicare and Medicaid enrollment for employed practitioners.
- Demonstrates knowledge of DMPN's Credentialing Plan and Guidelines; ongoing monitoring; credentialing standards for NCQA and TDI including Texas Administrative Codes pertaining to credentialing.
- Inputs credentialing data and maintains the accuracy and completeness of the fields in the DMPN database.
- Responsible for gathering DMPN credentialing/recredentialing documents and information; performs primary verification of credentialing information; reviews and analyzes the documentation for completeness and consistency; follows up on applications that are incomplete. Prepares completed files for review and approval by the DMPN Credentialing Committee and/or Chairman.
- Responsible for setting up electronic credentialing file for each practitioner and scanning and/or filing hard copies of credentialing documents into practitioners electronic or hard copy files.
- Responsible for completing and maintaining accurate and current information in employed practitioners' CAQH profiles.