Credentialing Specialist Job at CLS Health, Webster, TX

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  • CLS Health
  • Webster, TX

Job Description

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.

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