Credentialing Specialist - 100% Remote (Must Live in Greater Houston)

Houston Methodist•Houston, TX

3d•Remote

About The Position

FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) EXPERIENCE Three years of experience in the Medical Staff Credentialing/Privileging function in a hospital setting, with regular interaction and communication with medical staff and hospital leadership Three years of experience in word-processing and spreadsheet software such as Microsoft Word and Excel Experience with credentialing software preferred LICENSES AND CERTIFICATIONS Required Preferred CPMSM - Certified Professional Medical Services Management (NAMSS) or CPCS - Certified Provider Credentialing Specialist (NAMSS) SKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Self-motivated, detail-oriented, energetic, and able to prioritize multiple projects Knowledge of accreditation standards that relate to Medical Staff Services Computer literacy, including ability to utilize various software programs to complete all job tasks described in job summary. Must be proficient in word-processing and spreadsheet software such as Microsoft Word and Excel. Knowledge of credentialing software preferred General knowledge of medical terminology Ability to complete work within designated time frames Ability to offer suggestions and implement change to enhance efficiency and organization of office operations Ability to maintain confidentiality and privacy of practitioner files ESSENTIAL FUNCTIONS PEOPLE ESSENTIAL FUNCTIONS Prepares correspondence to practitioners, delegated entities and others. Handles resolution of complex problems and issues and notifies management of issue and resolution. Promotes a positive work environment and contributes to a dynamic, team-focused work unit that actively helps one other to achieve optimal department results. SERVICE ESSENTIAL FUNCTIONS Receives, data enters and organizes applications for appointment and reappointment. Performs primary source and other verifications necessary for completion of applications for appointment and reappointment. Gathers and compiles all other necessary documentation, including case logs or quality data, for application completion. Generates reports and checklists for the organization, tracking, auditing and communication of work in process or completed. Ensures all credentialing deadlines are met. QUALITY/SAFETY ESSENTIAL FUNCTIONS Investigates, clarifies and communicates discrepancies, sanctions, complaints, adverse data, etc., as per department policies. Ensures data entry, verifications and final applications are accurate and complete in the credentialing database. Updates database on an ongoing basis as necessary. FINANCE ESSENTIAL FUNCTIONS Assists with financial management tasks such as dues, fees, and/or payments. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Participates in department projects and activities. Seeks continuing education opportunities to expand learning beyond baseline competencies with a focus on continual development.

Requirements

High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
Three years of experience in the Medical Staff Credentialing/Privileging function in a hospital setting, with regular interaction and communication with medical staff and hospital leadership
Three years of experience in word-processing and spreadsheet software such as Microsoft Word and Excel
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
Self-motivated, detail-oriented, energetic, and able to prioritize multiple projects
Knowledge of accreditation standards that relate to Medical Staff Services
Computer literacy, including ability to utilize various software programs to complete all job tasks described in job summary.
Must be proficient in word-processing and spreadsheet software such as Microsoft Word and Excel.
General knowledge of medical terminology
Ability to complete work within designated time frames
Ability to offer suggestions and implement change to enhance efficiency and organization of office operations
Ability to maintain confidentiality and privacy of practitioner files

Nice To Haves

Experience with credentialing software preferred
CPMSM - Certified Professional Medical Services Management (NAMSS) or CPCS - Certified Provider Credentialing Specialist (NAMSS)

Responsibilities

Prepares correspondence to practitioners, delegated entities and others.
Handles resolution of complex problems and issues and notifies management of issue and resolution.
Promotes a positive work environment and contributes to a dynamic, team-focused work unit that actively helps one other to achieve optimal department results.
Receives, data enters and organizes applications for appointment and reappointment.
Performs primary source and other verifications necessary for completion of applications for appointment and reappointment.
Gathers and compiles all other necessary documentation, including case logs or quality data, for application completion.
Generates reports and checklists for the organization, tracking, auditing and communication of work in process or completed.
Ensures all credentialing deadlines are met.
Investigates, clarifies and communicates discrepancies, sanctions, complaints, adverse data, etc., as per department policies.
Ensures data entry, verifications and final applications are accurate and complete in the credentialing database.
Updates database on an ongoing basis as necessary.
Assists with financial management tasks such as dues, fees, and/or payments.
Participates in department projects and activities.
Seeks continuing education opportunities to expand learning beyond baseline competencies with a focus on continual development.