[Hiring] Credentialing Specialist @St. Joseph Health

Role Description

As a Credentialing Professional, you will be responsible for coordinating the credentialing, re-credentialing, and payer enrollment process for providers in accordance with delegated credentialing agreements, policies and procedures, industry best practices, and regulatory requirements.

• Manage daily credentialing operations, including resolution of non-responsive providers.
• Work collaboratively with various clinic managers and the hospital medical staff office to ensure the successful and timely completion of the delegated credentialing and re-credentialing process.
• Demonstrate a comprehensive understanding of credentialing regulations and processes.
• Possess strong organizational and communication skills.
• Effectively manage complex administrative tasks to ensure provider compliance and efficient operational flow.
• Manage the process of sending initial and/or reappointment applications and monitoring their return with required documents.
• Responsible for processing appointment/reappointment applications in an accurate, thorough, and timely manner; clearly and succinctly communicate reappointment status to applicant in writing.
• File appointment/reappointment applications and other communication as needed.
• Prepare files and other documents, as requested, for review and evaluation of the clinical Service Chief and Credentials Committee in an accurate, consistent, professional, and organized manner.
• Perform 3rd party verifications of submitted material as required by department policy, medical staff policy, and the Bylaws of the Medical Staff.
• Document receipt of application materials and verifications in the credentialing system (ECHO) (e.g. Texas Medical License, Malpractice Insurance, DEA, Board Certification, DPS, etc.). File copy in physician's file.

Qualifications

• High School Graduate General Studies, upon hire or
• High School GED General Studies, upon hire
• None, upon hire

Company Description

St. Joseph Health has been caring for the communities in and surrounding the Brazos Valley since 1936 (Bryan/College Station, Navasota, Caldwell, Madisonville (TX)).

• St. Joseph has a Level III Trauma Center, the first Joint Commission certified Primary Stroke Center and the first accredited Chest Pain Center in the Brazos Valley.
• Leader in critical care and the largest provider of cardiovascular care in the region.
• Includes a comprehensive network of over 100 employed providers including primary care physicians, specialists, and advanced practice clinicians.
• Network includes more than 30 ambulatory clinics featuring Primary Care, Express Clinics, and Imaging and Diagnostic Services.