Credentialing Analyst Cvo-Staff Credentialing
Company: Christus Health
Location: Texarkana
Posted on: March 26, 2025
Job Description:
Description
Summary: The Credentialing Analyst is responsible for leading,
coordinating, monitoring, analyzing, and maintaining the
credentialing expirables process and overseeing the review and
monitoring of sanctions and disciplinary actions. Ensures
compliance with accrediting and regulatory agencies by developing
and maintaining a thorough understanding of relevant statutes,
laws, and industry standards. Continuously monitors and ensures
that the credentialing process aligns with current legal
requirements, including regular review of provider sanctions.
Accountable for maintaining the accuracy, integrity, and
confidentiality of data within the credentialing database, ensuring
timely updates, and reporting as needed. Responsibilities:
- Meets expectations of the applicable OneCHRISTUS Competencies:
Leader of Self, Leader of Others, or Leader of Leaders.
- Conducts thorough investigation, research, and primary source
verification of all expirable.
- Identifies issues that require additional investigation and
evaluation, validates discrepancies, and ensures appropriate
follow-up.
- Prepares and sends monthly expirable reports to clients.
- Meets weekly performance metrics which includes amount of
expirable completed and data integrity.
- Utilizes and maintains the credentialing database, optimizing
efficiency, and performs queries, reports, and document
generation.
- Monitors the initial, reappointment, and expirable process for
practitioners, ensuring compliance with regulatory bodies (Joint
Commission, NCQA, URAC, CMS, Federal/State), bylaws,
policies/procedures, and delegated agreements
- Maintains strict confidentiality of all data and
information.
- Monitors and reviews sanctions and disciplinary actions,
ensuring compliance, timely follow-up, and accurate documentation
in the credentialing process.
- Maintain accurate and up-to-date practitioner data within
credentialing systems, adhering to established guidelines and
procedures.
- Utilize credentialing systems to efficiently manage and enhance
the credentialing process.
- Ensure data accuracy and integrity through attention to detail
and adherence to established standards.
- Maintain a comprehensive understanding of accreditation,
certification, and credentialing/privileging procedures to ensure
compliance with regulatory requirements.
- Performs miscellaneous job-related duties as assigned. Job
Requirements: Education/Skills
- High School Diploma or GED required Experience
- 1 year of experience related to hospital or managed care
credentialing required Licenses, Registrations, or Certifications
- Certified Provider Credentialing Specialist (CPCS) preferred
Work Schedule: TBD Work Type: Full Time EEO is the law - click
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Keywords: Christus Health, Longview , Credentialing Analyst Cvo-Staff Credentialing, Professions , Texarkana, Texas
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