Credentialing Coordinator

CLS Health PLLC•Webster, TX

35d

About The Position

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! The Credentialing Coordinator is responsible for managing and maintaining the credentialing and re-credentialing process for healthcare providers to ensure compliance with organizational standards, regulatory requirements, and payer guidelines. This role involves verifying provider qualifications, maintaining accurate records, and coordinating with internal teams and external agencies to ensure timely and accurate credentialing.

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 skills.
Proficiency in using credentialing software and databases.

Nice To Haves

Familiarity with medical terminology is a plus.

Responsibilities

Collect, review, and verify provider documentation including licenses, certifications, education, work history, and malpractice coverage.
Submit credentialing applications to insurance payers and monitor approval status.
Ensure compliance with state, federal, and accreditation standards (e.g., NCQA, CMS).
Maintain accurate and up-to-date credentialing files and databases.
Serve as the primary point of contact for providers regarding credentialing status and requirements.
Collaborate with internal departments such as HR, Provider Relations, and Billing to ensure seamless onboarding.
Update and maintain credentialing software systems and provider rosters.
Generate reports on credentialing status and timelines for leadership review.
Performs related duties as required.