Healthcare Credentialing & Compliance Specialist

CENTRO SAN VICENTE CLINIC; El Paso (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

Centro San Vicente Clinic in El Paso, TX is seeking a Credentialing Coordinator to oversee medical and allied health staff credentialing, reappointment, and privileging. You will ensure processes comply with bylaws, policies, Joint Commission, and federal/state standards.

The role involves reviewing applications, verifying licensure and certifications, maintaining databases, preparing reports for the Credentialing Committee, and coordinating with providers and departments to keep credentials

Qualifications

• Experience with credentialing processes and tracking systems.
• Knowledge of licensure verification, DEA/CSR, board certifications.
• Ability to investigate adverse or missing information.
• Experience producing reports for Credentialing Committee.
• Maintaining credentialing databases with accuracy.
• Knowledge of accrediting bodies’ requirements.
• HIPAA compliance and confidentiality.

Responsibilities

• Coordinate credentialing and re-credentialing applications for LIP and non-LIP.
• Verify licensure, DEA/CSR, board certs and education.
• Investigate adverse or missing information.
• Review credentials and report to Credentialing Committee.
• Produce scheduled and ad hoc credentialing reports.
• Maintain agenda and minutes for the Credentialing Committee.
• Maintain credentialing database and reminders for renewals.
• Review managed care contracts related to credentialing.
• Complete and execute MCO contracts with new/existing providers.
• Ensure data integrity and confidentiality.
• Communicate results to providers and Business Office.

Skills

Regulatory knowledge

HIPAA knowledge

Effective written and verbal comms

Computer literacy & database skills

Organizational & multi-tasking

Interpersonal skills

Teamwork

Education

Associate’s degree in Health Administration or related field

High School diploma or GED with related experience

Job description

Centro San Vicente Clinic in El Paso, TX is seeking a Credentialing Coordinator to oversee medical and allied health staff credentialing, reappointment, and privileging. You will ensure processes comply with bylaws, policies, Joint Commission, and federal/state standards.

The role involves reviewing applications, verifying licensure and certifications, maintaining databases, preparing reports for the Credentialing Committee, and coordinating with providers and departments to keep credentials