System Credentialing Coordinator

Memorial Hermann Health System; Houston (TX); Presencial; USD 50.000 - 70.000; Jornada completa

Descripción de la vacante

A leading health care system in Houston is seeking a System Credentialing Coordinator responsible for coordinating credentialing and re-credentialing of physicians and providers. Key responsibilities include implementing procedures, processing applications, and serving as a liaison during credentialing. Candidates should have three years of credentialing experience, strong analytical, and communication skills. This is a full-time role offering competitive benefits and the opportunity to contribute to the health care community.

Formación

• Three years of credentialing experience in a managed care plan or similar.
• Proficient understanding of Joint Commission, NCQA, and URAC accreditation standards.
• Knowledge of initial credentialing practices and primary source verification methods.

Responsabilidades

• Coordinate credentialing, re-credentialing, and privileging of network providers.
• Process provider applications and maintain provider profiling system.
• Serve as a liaison during credentialing processes.

Conocimientos

Analytical skills

Communication skills

Computer skills (Microsoft Office)

Educación

Associate's degree preferred

Descripción del empleo

System Credentialing Coordinator

Position at Memorial Hermann Health System.

Job Summary

The Senior Credentialing Specialist is responsible for the coordination of all activities associated with the credentialing and re‑credentialing of physicians and providers. The role ensures that credentialing policies and procedures meet all organizational, state regulatory, and external accreditation requirements. This position reports to the Manager of Credentialing.

Principal Accountabilities

• Implement and monitor procedures and activities related to the credentialing, re‑credentialing and privileging of network providers.
• Process provider applications and re‑applications, including initial mailing, review, and loading of the database to ensure high quality standards.
• Lead training initiatives for less experienced specialists, proctor credentialing exams, and conduct regular file audits.
• Maintain provider profiling system and communicate with providers by phone and mail regarding credentialing status.
• Provide guidance or expertise to less experienced specialists.
• Serve as a liaison during the credentialing processes, communicating with providers in a timely manner.
• Assist in managing policies and procedures related to credentialing and provider delegation maintenance.
• Ensure safe care for patients, staff and visitors while adhering to all Memorial Hermann policies, procedures, and standards within budgetary specifications.
• Promote professional growth by meeting mandatory/continuing education and competency requirements.
• Demonstrate commitment to caring for every member of the community through compassionate and personalized experiences.
• Perform other duties as assigned.

Minimum Qualifications

• Associate's degree preferred.
• Three (3) years of credentialing experience in a managed care plan, Medical Staff Services, or credentialing verification office.
• Strong analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
• Effective oral and written communication skills.
• Basic computer skills: Microsoft Office, Word and Excel.
• Proficient understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards.
• Demonstrated understanding of initial credentialing and re‑credentialing practices for medical professionals, including primary source verification methods and compliance monitoring.

Seniority Level

Mid‑Senior level

Employment Type

Full‑time

Job Function

Health Care Provider

Industries

Hospitals and Health Care