Credentialing Specialist Job at Astrana Health, Inc., Houston, TX

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  • Astrana Health, Inc.
  • Houston, TX

Job Description

Job Description

Job Description

Description

Job Title: Credentialing Specialist 
Department: Operations - Credentialing 

We are currently seeking a highly motivated Credentialing Specialist. This role will report to the Supervisor - Credentialing and enable us to continue to scale in the healthcare industry. The Credentialing Specialist fulfills all activities required for successful completion of initial and re-credentialing applications. Key responsibilities include Credentialing Committee preparation and scheduling, responding to health plan credentialing audits, and successful integration of credentialing files for newly acquired entities. This is a hybrid/remote role where the expectation is to work both in office and at home on a weekly basis (dependent on the employee’s location). 
What You'll Do
  • Process initial and reappointment credentialing applications and conduct follow up as needed 
  • Quality spot check applications before submission to committee
  • Prepare monthly reports for peer review/credentialing committee meetings 
  • Input all credentialing data into credentialing software database accurately and timely 
  • Work closely with IPAs and Hospitals to ensure exceptional customer service 
  • Maintain provider state licenses, DEA certificates, malpractice insurance and any other required credentialing documents 
  • Represents the MSO while interacting with internal and external contacts 
  • Remain up to date with credentialing accreditation standards with NCQA and Joint Commission 
  • Knowledge of current credentialing standards published by Joint Commission and/or NCQA 
  • Ability to analyze complex application problems and provide solutions • Ability to work with multiple projects and deadlines 
  • Excellent written and verbal communication skills 
  • Detail oriented and possess strong organizational skills in a fast-pace environment 
Qualifications:
  • High School Diploma, Bachelor’s Degree preferred
  • Licensure, Certification, Registration: CPCS or CPMSM certification 
  • 2-3 years’ credentialing experience within a managed care, hospital or CVO credentialing 
Environmental Job Requirements and Working Conditions
  • This position is in office with the option to be hybrid or remote (dependent on the employee’s location. 
  • The office is located at 19500 Hwy 249 Suite 570 Houston, TX 77070. 
  • The total compensation target pay range for this role is: $20.00 to $25.00 per hour. The salary range represents our national target range for this role.

Job Tags

Hourly pay, Work at office, Remote work,

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