Credentialing Coordinator / Senior - Orthopedics

Position Summary:
This position is responsible for supporting and coordinating all provider and physician credentialing activities. The Credentialing Coordinator verifies that all policies and procedures associated with credentialing meets external accreditation, state regulatory requirements, and organizational requirements.
Position Key Accountabilities:

• Essential Functions
  
• Conducts credentialing and re-credentialing related activities.
• Monitors and maintains credentialing databases and files for practitioners and providers.
• Facilitates applications and re-applications for providers per company and state requirements.
• Communicates with providers in a timely manner regarding status of credentialing via written or verbal communication.
• Maintains additions, changes, and terminations in credentialing database.
• May facilitate new provider orientation and onboarding.
• May manage policies and procedures associated with provider credentialing.
• Conducts credentialing audits and satisfaction surveys.
• Effectively communicates with all stakeholders.
• Continuous compliance with HIPPA regulations and Compliance/Program Integrity requirements.
• Performs other duties as assigned.

Certification/Skills:

• Current and thorough knowledge of all rules, laws, regulations, accreditation requirements and standards relevant to credentialing.
• Knowledgeable of NCQA, URAC, and Joint Commission standards and requirements of accreditation.
• Proficiency (intermediate) with MS Office software, Word, Excel.
• Demonstrated effective written and oral communication skills.
• Manages Human Resources activities of department in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning.
• Certified Provider Credentialing Specialist (CPCS) by National Association Medical Staff Services (NAMSS) preferred

Minimum Education:
Associate's Degree in related field required May substitute required education with equivalent years of experience beyond the minimum experience requirement.
Minimum Experience:
3 years of credentialing, database management, or medical staff coordination in managed care environment required
Physical Requirements:
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
Security Sensitive:
This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.
Residency Requirement:

Employees must permanently reside and work in the State of Texas.