Credentialing Specialist

Full Time
Pearland, TX 77584
Posted
Job description
Overview:
Kelsey-Seybold Clinic, a Houston tradition in patient-centered care, is a multispecialty clinic with over 25 locations and comprises more than 500 physicians providing primary and specialty care in a collaborative manner.

With 55 different clinical and non-clinical specialties, you can design a career path at Kelsey-Seybold Clinic that allows you to grow your future in a completely new direction.

Kelsey-Seybold Clinic is changing the way health cares.
Responsibilities:
The Credentialing Specialist will be responsible for the credentialing and recredentialing of all employed Kelsey-Seybold physicians and contracted affiliated providers. The functions include but are not limited to initial and recredentialing applications, mailing and tracking of all applications, primary source verifications, file production and maintenance, presentation at Credentialing Committee, internal and external communication of outcome reporting, liaison with designated payors regarding the delegation of credentialing/recredentialing to Kelsey-Seybold (initial assessments, onsite audits, corrective action plans and submission of monthly reports), hospital privileges, assist with credentialing subdelegations and tracking of licensure/certification expirations
Qualifications:
Credentialing Specialist
Location: Pearland Administrative Office
Department: Gen Admin - Community Network Op
Job Type: Full-Time

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Education

A.

High School diploma or G.E.D.

B.

College Degree, Certification

Experience

A.

2 - 3 years Credentialing experience with hospital application experience or managed care experience

B.

Special Skills

A.

Proficient: Microsoft Access, Word and Excel

B.

Knowledge of AAAHC, NCQA and TDI credentialing standards, Midas Seeker

Other

A.

Capable of sitting for extended periods of time.

B.

Self starter who can work independently with minimal supervision

WORKING ENVIRONMENT
Office

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