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Credentialing Coordinator

Location: Schertz, TX, United States
Job Type: Full Time
Job Category: Administrative
Job Industry: Healthcare Systems and Services
Salary: The pay we're offering is $17 per hour
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The Opportunity

Description

We're looking for a Credentialing Coordinator, working in Healthcare Systems and Services industry in Schertz, Texas, United States.

  • Leads, coordinates and monitors the review and analysis of Nexus panel members and accompanying documents, ensuring continued applicant eligibility.
  • Facilitates all aspects of credentialing, including initial panel entry, re-credentialing, expirable process and required documentation.
  • Ensures interpretation and compliance with the appropriate accrediting and regulatory agency (URAC), while developing and maintaining a working knowledge of the statutes and laws relating tom credentialing.
  • Ensures a Best Practice level of interpretation and integrity when processing credentialing documentation.
  • Maintains accuracy and integrity of the credentialing database system and related applications.
  • Works in cooperation with the Nexus Physician Recruiters communicating verbally and electronically with potential panel members (physicians and allied health professionals).
  • Communicates promptly and professionally by providing all credentialing paperwork and packets with instructions to each potential panel member regarding the credentialing process.
  • Directly receives, organizes, and documents all needed credentialing documents of contracted physicians and allied health professionals.
  • Manages primary source verification of all credentialing documents.
  • Ensures full completion of all documents and individual audit of any outliers.
  • Analytically and structurally seeks out inconsistencies in paperwork or written/verbal communication, and work quickly to rectify them.
  • Conducts thorough background investigation, research and primary source verification discrepancies and ensures appropriate follow up.
  • Submits and retrieves National Practitioner Database reports in accordance with Health Care Quality Improvement Act.
  • Pulls various regulatory reports for incoming panel members to include OIG, SAM, Texas Medical Board, HCSC, etc.
  • Prepares credentials file for completion and presentation to Nexus Credentialing Committee, ensuring file completion with time periods specified.
  • Utilizes credentialing database, optimizing efficiency. Performs query, report and document generation.
  • Maintains databases and required spreadsheets containing new and/or updated information regarding panel training, licenses, education, continuing education and URAC required documentation.
  • Tracks panel member referrals and notify Director of Operations when referral fee payment becomes eligible.

Our Client

Our client provides outsourcing, staffing, consulting and workforce solutions. Hiring for Engineering, Finance and Accounting, Healthcare, Human Resources, IT, Legal, Life Sciences, Manufacturing and Logistics, Sales and Marketing and Administrative roles. For 60 years. Via 5,000 offices in 39 countries.

Matching smart people with great jobs. Putting to work nearly 700,000 employees worldwide.

Helping people like you achieve your potential. Using innovative technologies and passion for people to provide you the best experience possible. Every single day.

Let this be your day. Put their expertise to work for you. You deserve it!

Experience Required for Your Success

  • High school diploma or equivalent
  • 2 years experience in multi-task driven work environment, requiring high level organization skills
  • Knowledge of related accreditation and certification requirements
  • Knowledge of medical credentialing procedures and standards
  • Strong organizational and task prioritization skills
  • Program planning and implementation skills
  • Database management skills including querying, reporting and document generation
  • Informational research skills
  • Professional in appearance
  • Ability to type with the above proficiency
  • Ability to communicate orally and written
  • Ability to analyze, interpret and draw inferences from research findings and prepare reports
  • Ability to use independent judgment to manage and impart confidential information
  • Ability to make administrative/procedural decisions and judgments
  • Computer literacy on Microsoft Office products and data base programs

What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible? Apply Now

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