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

aWlmTnF3aW1Xd3ExU1hSMXBqeXpMUkxn
  • 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,

Similar Jobs

SelfHacked

Wordpress Developer Part Time Job at SelfHacked

Job Type and Pay: We are looking for a talented WordPress developer. Pay will be in accordance with abilities and experience. Position...  ..., readable code At least 3 Years of experience with web development in WordPress Experience with PHP and HTML/... 

Insight Global

Acoustical Ceiling Installer Job at Insight Global

 ...Job: Acoustical Ceiling Installer Location: Garner, NC Duration: Permanant Pay Rate: $25/hr - $30/hr JOB DESCRIPTION: An engineering client is seeking to hire an Acoustical Ceiling Mechanic. In the role, you will play a critical role in the installation... 

Baltimore Country Club

Valet Attendant Job at Baltimore Country Club

 ...looking for candidates with exceptional driving abilities to join our Valet team! ABOUT BALTIMORE COUNTRY CLUB Baltimore Country Club...  ...and professional manner. Attendants will provide valet parking services by safely and efficiently moving automobiles to a designated... 

Venters Recruits

Inside Sales Representative - Base plus commission Job at Venters Recruits

 ...Job Description Job Description Base Salary $ 60 to 65K plus commission (O.T.E. 70K to 90K) As a keen inside sales/customer service specialist, you will be accountable for defined customer segments with detailed budgets and objectives. You will be servicing existing... 

Valley Fitness - Modesto

Personal Fitness Trainer Job at Valley Fitness - Modesto

 ...Job Description Job Description Our fitness studio is rapidly expanding, and we need a personal trainer to assist our clients in reaching their fitness objectives. You'll be working with clients to assess their fitness levels, develop customized training routines,...