Credentialing Coordinator

Credentialing Specialist

Hours of Work:

Days Of Week:

Work Shift:

Job Description:

Your Job Requirements:

• Some college or college degree preferred but not required. Certified Provider Credentialing Specialist (CPCS) preferred but not required. Experience in using Windows and various software applications including MD Staff, Excel Word and Outlook. Multitasking skills. Work Experience: 1-4 years experience

Your Job Responsibilities:

• Demonstrates knowledge of DMPN's Credentialing Plan and Guidelines; ongoing monitoring; credentialing standards for NCQA, URAC, CMS, TDI including Texas Administrative Codes pertaining to credentialing.

• Responsible for inputting credentialing data, maintaining the accuracy and completeness of the fields in MD Staff for all participating practitioners and for building customized reports in MD Staff.

• Responsible for gathering credentialing/recredentialing documents and information; performs primary source verification of credentialing information; reviews and analyzes the documentation for completeness and accuracy; investigates any red flags/issues; follows up on applications that are incomplete.

• Prepares completed files for review and approval by the Credentialing Committee or Chair.

• Responsible for setting up electronic credentialing file for each practitioner and saving credentialing documents into practitioners' electronic files.

• Responsible for tracking, obtaining and reviewing current expirables for practitioners.

• Assists in preparing for annual delegated credentialing health plan audits

• Other duties as assigned.

Additional Job Description

Job summary:

• Ability to multitask with minimal errors and utilize critical thinking skills.

• Must be able to maintain the confidentiality of data.

• Must be detail oriented, organized, self-starter, and have an ability to prioritize workload.

• Ability to analyze and interpret data and solve practical problems in independent and team environments.

• Ability to work under deadlines and manage multiple projects while completing work in an accurate and timely manner.

• Strong verbal and written communication skills.

• Responsible for data integrity, accuracy, and consistency.

• Interacts with physicians and practice administrators to secure required information.

Supports the mission, vision, values and strategic goals of Methodist Health System.

Adheres to DMPN's procedures and guidelines.

Adheres to MHS's procedures and guidelines.

Dallas Methodist Physicians Network (DMPN) is an Independent Practitioner Association (IPA) affiliated with Methodist Health System (MHS). Practitioners affiliated with MHS participate in DMPN's managed care plans. DMPN also handles the credentialing for the MHS Accountable Care Organization (ACO).

Human Resources

1. Provide Human Resources support to new employees during the on-boarding process to include scheduling pre-employment physicals, new hire paperwork, benefits and the coordination of orientation and necessary computer training.

2. Work with MHS Employee Health to coordinate the completion of follow-up pre-employment requirements.

3. Pre-screen applicants as part of the recruitment process.

4. Prepare new hire folders.

5. Initiate the background check process on prospective applicants.

6. Assist with scheduling interviews.

7. Assist in keeping employee files updated.

Job requirements: Knowledge of the most current credentialing forms required by CMS, TMHP and TDI. Skill in using computer and calculator. Ability to examine documents for accuracy and completeness. Ability to prepare applications in accordance with detailed instructions. Skill in defining problems and necessary collecting data. Ability to work effectively with physicians and co-workers. Ability to communicate clearly, both verbally and written.

Education: High School Diploma or GED.

Experience and skills Minimum One year of credentialing and working with health plans. Proficient computer skills with a strong emphasis with MS Excel.

Physical demands: Requires sitting for long periods of time. Working in an office environment. Some bending and stretching required. Working under stress and use of telephone required. Manual dexterity required for use of computer keyboard.

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we've earned:

• Great Place to Work Certified 2026-2027
• Glassdoor's Best Places to Work 2025 & 2026
• Glassdoor's Best Places to Work in Healthcare, Biotech & Pharma 2026
• TIME's Best Companies for Future Leaders 2025 & 2026
• Newsweek's America's Most Admired Workplaces 2026
• Glassdoor's Best-Led Companies 2025
• Fortune Best Workplaces in Health Care 2025
• Military Friendly Gold Employer 2025
• Becker's Hospital Review 150 Top Places to Work in Healthcare 2025
• Newsweek's Americas Greatest Workplaces 2025