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Req. No

117371

Job Title

Credentialing Auditor

Market

CHRISTUS System Office

Category

Clinical Support

Facility

CHRISTUS Corp Irving Offices 919 and 909 Buildings

Address

919 Hidden Ridge
Irving, TX  75038
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Type

FULL TIME

Credentialing Auditor Job in Irving

Job Description

Summary:

Responsible for auditing all complete credentialing applications and to build sound, effective and efficient audit processes.

  • Coordinate and execute credentialing audits by analyzing provider files for completeness, accuracy, consistency, gaps in employment history, pertinent references, etc.
  • Prepare credentialing audit reports and assist in the development of staff training guides, policies, and procedures.
  • Manages multiple concurrent audits, plan audits, and related projects while ensuring that all audit tools meet NCQA, TJC, and CMS requirements.
  • Responsible for educating and re-educating Associates.
  • Maintains strict confidentiality over all information and data.
  • Completes as-assigned miscellaneous work-related tasks.
  • Consistently meets weekly performance metrics.
  • Monitors the Credentialing Coordinators' quality metrics and identifies areas for improvement.

Requirements:

  • Bachelor’s degree preferred or equivalent job-related experience
  • Minimum of at least (3) years’ experience in medical staff and/or managed care credentialing required
  • Certified Provider Credentialing Specialist (CPCS) preferred

Work Type:

Full Time



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Credentialing Auditor