Credentialing Specialist

Description

About CLS Health

CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians!

Job Summary: The Credentialing Specialist plays a vital role in the healthcare industry by ensuring that all healthcare providers within an organization meet the necessary qualifications, certifications, and credentials required to provide high-quality patient care. The role involves working closely with medical staff, administrative personnel, and external regulatory bodies to ensure compliance and accuracy in credentialing processes.

Responsibilities

• Coordinate and oversee the credentialing and re-credentialing processes for all healthcare providers, including physicians, nurses, allied health professionals, and other medical staff.
• Maintain up-to-date knowledge of relevant regulations, accreditation standards, and best practices related to credentialing and privileging.
• Collect, review, and verify provider application materials, including licenses, certifications, educational qualifications, work history, malpractice insurance, and references.
• Collaborate with various departments to ensure timely completion of all necessary forms and documentation.
• Conduct primary source verification of credentials and licenses through appropriate channels.
• Maintain a comprehensive and accurate database of provider credentials, licenses, and certifications.
• Ensure that all records are consistently updated to reflect any changes or updates to provider credentials.
• Monitor and ensure compliance with accrediting and regulatory agency requirements related to provider credentials and privileging.
• Stay informed about changes in regulations and requirements that could impact the credentialing process.
• Liaise with medical staff, human resources, legal, and administrative teams to facilitate a smooth credentialing process.
• Communicate effectively with providers and external organizations to gather necessary information and resolve any credentialing-related issues.
• Assist in the onboarding and orientation of new healthcare providers, ensuring they are familiar with the organization's policies and procedures.
• Generate regular reports on the status of provider credentialing and re-credentialing processes for management and regulatory purposes.
• Identify opportunities for process improvements and efficiencies in the credentialing process and contribute to the implementation of best practices.
• Performs related duties as required.
• Office-Based Position
  
  

Benefits

• 401(k)
• 401(k) matching
• Dental Insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision Insurance
  
  

Requirements

• Bachelor's degree in healthcare administration, business administration, or a related field (or equivalent experience).
• Knowledge of healthcare regulations, accreditation standards, and credentialing requirements.
• Strong attention to detail and accuracy in record-keeping.
• Effective communication and interpersonal abilities.
• Proficiency in using credentialing software and databases.
• Familiarity with medical terminology is a plus.