Credentialing Coordinator

Job Summary Acredentialing Specialist who demonstrates knowledge of DMPN’s Credentialing Plan and Guidelines, including NCQA, URAC, CMS, TDI, and Texas Administrative Codes. Requires strong multitasking, critical thinking, and data integrity skills while interacting with physicians and practice administrators. Responsibilities Maintain accurate and complete credentialing data in MD Staff for all participating practitioners. Create customized reports in MD Staff. Gather, verify, and analyze credentialing and recredentialing documents, investigating red flags and following up on incomplete applications. Prepare completed files for review and approval by the Credentialing Committee or Chair. Set up electronic credentialing files for each practitioner and store documents in their electronic files. Track current expirables and assist with annual delegated credentialing health plan audits. Human Resources Support Assist new employees with onboarding, including scheduling pre‑employment physicals, completing paperwork, benefits enrollment, and orientation training. Coordinate follow‑up pre‑employment requirements with MHS Employee Health. Pre‑screen applicants, prepare new hire folders, initiate background checks, and schedule interviews. Maintain employee files and assist with related administrative tasks. Requirements & Qualifications Some college or college degree preferred. Certified Provider Credentialing Specialist (CPCS) preferred. Experience using Windows and software such as MD Staff, Excel, Word, and Outlook. 1–4 years of credentialing experience. Knowledge of current CMS, TMHP, and TDI credentialing forms. Strong computer skills, especially MS Excel. Excellent written and verbal communication. Ability to examine documents for accuracy and completeness. Detail‑oriented, organized, self‑starter with strong prioritization skills. Capacity to work independently and in team environments under deadlines. Education High School Diploma or GED required. Experience & Skills Minimum one year credentialing and experience working with health plans. Physical Demands Requires prolonged sitting, occasional bending and stretching, use of telephone, and manual dexterity for computer keyboard use. #J-18808-Ljbffr Methodist Health System