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Credentialing Specialist

Pulse Staffing Houston Contractor
$17.00/ hour
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Pulse Staffing has a contract position available for an experienced credentialing specialist. This position has the opportunity to extend with excellent job performance.


Position is responsible for:

• Perform the credentialing processes for all initial physician and provider applications and reappointment in a timely and complete manner.

• Collect and verify sensitive provider data through confidential sources and maintain a credentialing database.

• Perform relevant data entry into the database to ensure consistency and integrity of the data. In addition you will perform analysis and appropriate follow-ups of each initial application and reappointment application.

• Process appropriate queries for expired license, or any appropriate regulatory credentialing requirement and are required to maintain documentation in the database.

• Responsible for preparing files for presentation to the department chairman and credentials committee as well as attending medical staff meetings as directed by the supervisor of Medical Staff Services department.

• The Credentialing Specialist has knowledge of commonly-used concepts, practices, and procedures within medical staff services. They will rely on instructions and pre-established guidelines to perform the functions of the job and they work under general supervision.

• Your proficiency in in Windows-based word processing and spreadsheet software will allow for you to leverage your basic medical terminology as well as the basics records maintenance and retrieval systems


Location: Memorial City area, Houston, TX 77024

Schedule: Monday - Friday 8a-4p

  • Three (3) years of recent healthcare or managed care credentialing related experience
  • Strong analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
  • Effective oral and written communication skills.
  • Basic computer skills: Microsoft Office, Word and Excel
  • Proficient understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
  • Demonstrated understanding on initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, and compliance monitoring.
  • HS Diploma or GED required.

Skills required

Billing
Collections
Claims
Government
Insurance
Underwriting
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By developing lasting relationships and delivering consistent service, we’ve gained the trust of some of the most prestigious medical facilities in Texas. We gain a deep understanding of the operational goals and challenges of our employer partners to provide healthcare and support professionals that suit each facility or practice’s unique needs.

With offices in Houston, Beaumont and San Antonio, we are able to serve hospitals, physicians and insurance companies in Houston, San Antonio, Beaumont and Dallas.

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