Credentialing Auditor - Credentialing

Summary

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

Summary:

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

• Meets expectations of the applicable OneCHRISTUS
  
  Competencies:
  
  Leader of Self, Leader of Others, or Leader of Leaders.
• Coordinate and conduct credentialing audits analyzing provider files for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
• Prepare credentialing audit reports tracking and trending auditor findings and assist in the formulation of staff training guides, policies and procedures.
• Manages multiple concurrent audits, plan audits and related projects ensuring all audit tools comply with NCQA, TJC and CMS requirements.
• Coordinates the credentialing and re-credentialing process for assigned providers.

• Bachelor's Degree preferred
• High School or equivalent required

• 3 years of experience in medical staff and/or managed care credentialing preferred

• Certified Provider Credentialing Specialist (CPCS) preferred

8AM - 5PM Monday-Friday

Full Time