Credentialing Coordinator

Job Summary Ability to multitask with minimal errors and utilize critical thinking skills. Maintain the confidentiality of data. Detail oriented, organized, self‑starter, and able to prioritize workload. Analyze and interpret data and solve practical problems in independent and team environments. Work under deadlines and manage multiple projects while completing work accurately and timely. Strong verbal and written communication skills. Responsible for data integrity, accuracy, and consistency. Qualifications 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. 1–4 years of related work experience. Knowledge of the most current credentialing forms required by CMS, TMHP, and TDI. Skill in using a 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 collecting data. Ability to work effectively with physicians and co‑workers. Clear communication, both verbally and in writing. Experience and Skills Minimum one year of credentialing and working with health plans. Proficient computer skills with a strong emphasis on MS Excel. Physical Demands Requires sitting for long periods, working in an office environment, occasional bending and stretching, working under stress, use of telephone, and manual dexterity for computer keyboard. Your Job Responsibilities Demonstrate knowledge of DMPN’s Credentialing Plan and Guidelines; ongoing monitoring; credentialing standards for NCQA, URAC, CMS, TDI, and Texas Administrative Codes related to credentialing. Input credentialing data, maintain accuracy and completeness of MD Staff fields for all practitioners, and build customized MD Staff reports. Gather credentialing/recredentialing documents; perform primary source verification; review and analyze documentation for completeness and accuracy; investigate red flags or issues; follow 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 manage credentialing documents in practitioners’ electronic files. Track, obtain, and review current expirables for practitioners. Assist in preparing for annual delegated credentialing health plan audits. Other duties as assigned. Interact with physicians and practice administrators to secure required information. Support the mission, vision, values, and strategic goals of the organization. Adhere to DMPN’s and MHS’s procedures and guidelines. Human Resources Support Provide HR support during the onboarding process, including scheduling pre‑employment physicals, new hire paperwork, benefits, and coordinating orientation and computer training. Work with MHS Employee Health to coordinate the completion of follow‑up pre‑employment requirements. Pre‑screen applicants as part of the recruitment process. Prepare new hire folders. Initiate background check processes on prospective applicants. Assist with scheduling interviews. Assist in keeping employee files updated. Education High School Diploma or GED. #J-18808-Ljbffr