Credentialing Auditor - Staff Credentialing
CHRISTUS Health
Irving, TX
Summary:
Responsible for auditing all complete credentialing applications and to build sound, effective and efficient audit processes.
Responsibilities:
- Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Coordinate and conduct credentialing audits analyzing provider files for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
- Prepare credentialing audit reports tracking and trending auditor findings and assist in the formulation of staff training guides, policies and procedures Manages multiple concurrent audits, plan audits and related projects ensuring all audit tools comply with NCQA, TJC and CMS requirements Coordinates the credentialing and re-credentialing process for assigned providers
Requirements:
Education/Skills
- Bachelor's Degree preferred
- High School or equivalent required
Experience
- 3 years of experience in medical staff and/or managed care credentialing preferred
Licenses, Registrations, or Certifications
- Certified Provider Credentialing Specialist (CPCS) preferred
Work Schedule:
8AM - 5PM Monday-Friday
Work Type:
Full Time
About the Company
CHRISTUS Health
In 1999, two historic Catholic charities became one, forming CHRISTUS Health and creating a unique purpose in the modern health care market - to take better care of people.
To extend the healing ministry of Jesus Christ, the mission that the Sisters of Charity Health Care system and Incarnate Word Health system shared for more than a century, is now also the mission of CHRISTUS Health.
Ranked among the top 10 Catholic health systems in the United States by size, the CHRISTUS Health system includes more than 40 hospitals and facilities in seven U.S. states, Chile and six states in Mexico, with assets of more than $4.6 billion.
Whether seeking care in Alexandria Louisiana, or Coahuila, Mexico, patients discover that the healing spirit is alive at CHRISTUS Health.