What are the responsibilities and job description for the Credentialing Specialist position at CLS Health?
About CLS Health
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!
Job Summary:
The Credentialing Specialist plays a vital role in the healthcare industry by ensuring that all healthcare providers within an organization meet the necessary qualifications, certifications, and credentials required to provide high-quality patient care. The role involves working closely with medical staff, administrative personnel, and external regulatory bodies to ensure compliance and accuracy in credentialing processes.
Responsibilities:
- Coordinate and oversee the credentialing and re-credentialing processes for all healthcare providers, including physicians, nurses, allied health professionals, and other medical staff.
- Maintain up-to-date knowledge of relevant regulations, accreditation standards, and best practices related to credentialing and privileging.
- Collect, review, and verify provider application materials, including licenses, certifications, educational qualifications, work history, malpractice insurance, and references.
- Collaborate with various departments to ensure timely completion of all necessary forms and documentation.
- Conduct primary source verification of credentials and licenses through appropriate channels.
- Maintain a comprehensive and accurate database of provider credentials, licenses, and certifications.
- Ensure that all records are consistently updated to reflect any changes or updates to provider credentials.
- Monitor and ensure compliance with accrediting and regulatory agency requirements related to provider credentials and privileging.
- Stay informed about changes in regulations and requirements that could impact the credentialing process.
- Liaise with medical staff, human resources, legal, and administrative teams to facilitate a smooth credentialing process.
- Communicate effectively with providers and external organizations to gather necessary information and resolve any credentialing-related issues.
- Assist in the onboarding and orientation of new healthcare providers, ensuring they are familiar with the organization's policies and procedures.
- Generate regular reports on the status of provider credentialing and re-credentialing processes for management and regulatory purposes.
- Identify opportunities for process improvements and efficiencies in the credentialing process and contribute to the implementation of best practices.
- Performs related duties as required.
- Office-Based Position
Benefits:
- 401(k)
- 401(k) matching
- Dental Insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision Insurance
Requirements
- Bachelor's degree in healthcare administration, business administration, or a related field (or equivalent experience) preferred.
- Knowledge of healthcare regulations, accreditation standards, and credentialing requirements.
- Strong attention to detail and accuracy in record-keeping.
- Effective communication and interpersonal abilities.
- Proficiency in using credentialing software and databases.
- Familiarity with medical terminology is a plus.
