Credentialing Auditor-Staff Credentialing

Company: Christus Health
Location: Irving
Posted on: May 15, 2025

Job Description:

Description
Summary:

Responsible for auditing all complete credentialing applications and to build sound, effective and efficient audit processes.

Responsibilities:

--- Coordinate and execute credentialing audits by analyzing provider files for completeness, accuracy, consistency, gaps in employment history, pertinent references, etc. --- Prepare credentialing audit reports and assist in the development of staff training guides, policies, and procedures. --- Manages multiple concurrent audits, plan audits, and related projects while ensuring that all audit tools meet NCQA, TJC, and CMS requirements. --- Responsible for educating and re-educating Associates. --- Maintains strict confidentiality over all information and data. --- Completes as-assigned miscellaneous work-related tasks. --- Consistently meets weekly performance metrics. --- Monitors the Credentialing Coordinators' quality metrics and identifies areas for improvement.

Requirements:

• Bachelor's Degree preferred
• High School or equivalent required
• 3 years of experience in medical staff and/or managed care credentialing preferred
• Certified Provider Credentialing Specialist (CPCS) preferred
  
  Work Type:
  
  Full Time
  
  

Keywords: Christus Health, The Colony , Credentialing Auditor-Staff Credentialing, Accounting, Auditing , Irving, Texas