Centralized Credentialing Specialist

 
Position: Centralized Credentialing Specialist

Job ID: 151420

Location: US-TX-Houston

Department: CENTRALIZED CREDENTIALING

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for a Centralized Credentialing Specialist — someone who works well in a fast-paced setting. In this position, you will be the single point of contact and responsible for the managing and completing all credentialing functions related to the provider on-boarding process for members of the medical staff and the Physician Services Organization (TCPSO). You will be responsible for ensuring providers presented to the Credentials Committee, TCPSO

Credentials Committee and the Executive Vice President are of the highest quality and following Bylaws and Mission, Joint Commission (JC) standards and National Council of Quality Assurance (NCQA) guidelines.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities

HOU123

  • Determine applicant’s eligibility for membership/participation with medical staff & the physician services organization
  • Conduct and participate in audits of credentialing entities to ensure compliance with accreditation and regulatory standards by completing pre-audits on requested provider files
  • Provide education for onboarding providers and key stakeholders
  • Prioritize provider credentialing tasks and red flag reports when necessary to department leadership monthly
  • Assure that monthly and quarterly communications and reports from the Board of Directors and TCPSO Credentials Committee are completed

 



Qualifications:

Skills & Requirements

 

  • High school diploma or GED
  • Bachelor’s degree in business, finance, healthcare administration or accounting preferred
  • A minimum of 4 years’ experience in a physician practice, physician billing, hospital or a managed health care setting
  • At least 1 year of presentations, summary reports, and/or committee participation experience preferred
  • Certified Provider Credentialing Specialist from the National Association Medical Staff Services (NAMSS) preferred
  • Provider Enrollment Specialist Certificate (PESC) preferred
  • A bachelor’s degree in finance, accounting, business or healthcare administration may substitute for two years of the experience requirement

**Previous Credentialing experience highly preferred***



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