Credentialing Specialist - 100% Remote (Must Live in Greater Houston)
- Job Ref:
- JR-3091
- Time Type:
- Full Time
- Job Shift:
- Day
- Job Type:
- Full Time
Non-exempt
QUALIFICATIONS
EDUCATION
- High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE
- Three years of experience in the Medical Staff Credentialing/Privileging function in a hospital setting, with regular interaction and communication with medical staff and hospital leadership
- Three years of experience in word-processing and spreadsheet software such as Microsoft Word and Excel
- Experience with credentialing software preferred
LICENSES AND CERTIFICATIONS
Preferred
- CPMSM - Certified Professional Medical Services Management (NAMSS) or
- CPCS - Certified Provider Credentialing Specialist (NAMSS)
SKILLS AND ABILITIES
- Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
- Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
- Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
- Self-motivated, detail-oriented, energetic, and able to prioritize multiple projects
- Knowledge of accreditation standards that relate to Medical Staff Services
- Computer literacy, including ability to utilize various software programs to complete all job tasks described in job summary. Must be proficient in word-processing and spreadsheet software such as Microsoft Word and Excel. Knowledge of credentialing software preferred
- General knowledge of medical terminology
- Ability to complete work within designated time frames
- Ability to offer suggestions and implement change to enhance efficiency and organization of office operations
- Ability to maintain confidentiality and privacy of practitioner files
ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
- Prepares correspondence to practitioners, delegated entities and others.
- Handles resolution of complex problems and issues and notifies management of issue and resolution.
- Promotes a positive work environment and contributes to a dynamic, team-focused work unit that actively helps one other to achieve optimal department results.
SERVICE ESSENTIAL FUNCTIONS
- Receives, data enters and organizes applications for appointment and reappointment.
- Performs primary source and other verifications necessary for completion of applications for appointment and reappointment.
- Gathers and compiles all other necessary documentation, including case logs or quality data, for application completion.
- Generates reports and checklists for the organization, tracking, auditing and communication of work in process or completed.
- Ensures all credentialing deadlines are met.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
- Investigates, clarifies and communicates discrepancies, sanctions, complaints, adverse data, etc., as per department policies.
- Ensures data entry, verifications and final applications are accurate and complete in the credentialing database.
- Updates database on an ongoing basis as necessary.
FINANCE ESSENTIAL FUNCTIONS
- Assists with financial management tasks such as dues, fees, and/or payments.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
- Participates in department projects and activities.
- Seeks continuing education opportunities to expand learning beyond baseline competencies with a focus on continual development.
SUPPLEMENTAL REQUIREMENTS
- WORK ATTIRE
- Uniform: No
- Scrubs: No
- Business professional: Yes
- Other (department approved): No
- On Call* No
- May require travel within the Houston Metropolitan area Yes
- May require travel outside Houston Metropolitan area No
ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
TRAVEL**
**Travel specifications may vary by department**
EDUCATION
- High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE
- Three years of experience in the Medical Staff Credentialing/Privileging function in a hospital setting, with regular interaction and communication with medical staff and hospital leadership
- Three years of experience in word-processing and spreadsheet software such as Microsoft Word and Excel
- Experience with credentialing software preferred
LICENSES AND CERTIFICATIONS
Preferred
- CPMSM - Certified Professional Medical Services Management (NAMSS) or
- CPCS - Certified Provider Credentialing Specialist (NAMSS)
Company Profile:
Houston Methodist is one of the nation’s leading health systems and academic medical centers. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. Come lead with us!
Houston Methodist is an Equal Opportunity Employer.
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