Credentialing Auditor - Staff Credentialing
Not Disclosed•Full-TimeOn-site
location_on3505, Robin Lane, Texarkana, Bowie County, Texas, 75503, United States
About the Role
This position is dedicated to ensuring the integrity and efficiency of the credentialing process at OneCHRISTUS. The primary focus is on auditing all complete credentialing applications and building sound, effective, and efficient audit processes to support provider files.
In this role, you will coordinate and conduct credentialing audits, analyzing provider files for completeness, accuracy, consistency, gaps in work history, and relevant references. You will prepare credentialing audit reports that track and trend auditor findings, assisting in the formulation of staff training guides, policies, and procedures. Additionally, you will manage multiple concurrent audits, plan audits and related projects, and ensure all audit tools comply with NCQA, TJC, and CMS requirements. The role also involves coordinating the credentialing and re-credentialing process for assigned providers.
Work Environment
This is a full-time position with a standard work schedule from 8 AM to 5 PM, Monday through Friday. The role requires adherence to OneCHRISTUS Competencies, specifically demonstrating leadership as a Leader of Self, Leader of Others, or Leader of Leaders.
Work location
Work model: On-site
3505, Robin Lane, Texarkana, Bowie County, Texas, 75503, United States
Texarkana, Texas
Key Responsibilities
- check_circleCoordinate and conduct credentialing audits analyzing provider files for completeness and accuracy
- check_circlePrepare credentialing audit reports tracking and trending auditor findings
- check_circleAssist in the formulation of staff training guides, policies and procedures
- check_circleManage multiple concurrent audits and plan related projects
- check_circleEnsure all audit tools comply with NCQA, TJC and CMS requirements
- check_circleCoordinate the credentialing and re-credentialing process for assigned providers
Requirements
- verifiedHigh School or equivalent
- verified3 years of experience in medical staff and/or managed care credentialing preferred
- verifiedBachelor's Degree preferred
- verifiedCertified Provider Credentialing Specialist (CPCS) preferred
Nice to Have
Bachelor's Degree, 3 years of experience in medical staff and/or managed care credentialing, Certified Provider Credentialing Specialist (CPCS)
Similar Job Opportunities
Skills, education and keywords
Skills: Certified Provider Credentialing Specialist, Ncqa, TJC, CMS.
Education: Bachelor's Degree preferred; High School or equivalent required.
Frequently asked questions about Credentialing Auditor - Staff Credentialing at CHRISTUS Health
What does a Credentialing Auditor - Staff Credentialing at CHRISTUS Health do?expand_more
In this Credentialing Auditor - Staff Credentialing at CHRISTUS Health role, you will coordinate and conduct credentialing audits analyzing provider files for completeness and accuracy; prepare credentialing audit reports tracking and trending auditor findings; assist in the formulation of staff training guides, policies and procedures; and manage multiple concurrent audits and plan related projects.
What are the requirements for this Credentialing Auditor - Staff Credentialing role?expand_more
To qualify for the Credentialing Auditor - Staff Credentialing at CHRISTUS Health position, applicants should have: High School or equivalent; 3 years of experience in medical staff and/or managed care credentialing preferred; Bachelor's Degree preferred; and Certified Provider Credentialing Specialist (CPCS) preferred.
Where is the Credentialing Auditor - Staff Credentialing role at CHRISTUS Health located?expand_more
Credentialing Auditor - Staff Credentialing at CHRISTUS Health is based in 3505, Robin Lane, Texarkana, Bowie County, Texas, 75503, United States. This is a on-site role.
Is this Credentialing Auditor - Staff Credentialing job remote, hybrid, or on-site?expand_more
CHRISTUS Health has listed this Credentialing Auditor - Staff Credentialing role as on-site.
How much experience is required for this Credentialing Auditor - Staff Credentialing role?expand_more
Credentialing Auditor - Staff Credentialing at CHRISTUS Health typically requires 3+ years of relevant experience at the mid level level.
What skills do you need for the Credentialing Auditor - Staff Credentialing role at CHRISTUS Health?expand_more
Key skills for Credentialing Auditor - Staff Credentialing at CHRISTUS Health include Certified Provider Credentialing Specialist; Ncqa; TJC; and CMS.
What education is required for Credentialing Auditor - Staff Credentialing at CHRISTUS Health?expand_more
Educational requirements for this role: Bachelor's Degree preferred; and High School or equivalent required.
What category does the Credentialing Auditor - Staff Credentialing role belong to?expand_more
Credentialing Auditor - Staff Credentialing at CHRISTUS Health is part of the accounting & finance job category on Recrutus.