The Credentialing Specialist is responsible for processing applications for appointment and reappointment to the Medical Staff of Houston Methodist hospitals per applicable accreditation, bylaws and rules and regulations standards and deadlines. Additionally, current and accurate practitioner demographic, licensure and privileging information will be maintained utilizing credentialing and other designated software and in hard copy as required.

　　PEOPLE ESSENTIAL FUNCTIONS

　　Prepares correspondence to practitioners, delegated entities and others.

　　Handles resolution of complex problems and issues and notifies management of issue and resolution.

　　SERVICE ESSENTIAL FUNCTIONS

　　Receives, data enters and organizes applications for appointment and reappointment.

　　Performs primary source and other verifications necessary for completion of applications for appointment and reappointment.

　　Gathers and compiles all other necessary documentation, including case logs or quality data, for application completion.

　　Generates reports and checklists for the organization, tracking, auditing and communication of work in process or completed.

　　Ensures all credentialing deadlines are met.

　　QUALITY/SAFETY ESSENTIAL FUNCTIONS

　　Investigates, clarifies and communicates discrepancies, sanctions, complaints, adverse data, etc., as per department policies.

　　Ensures data entry, verifications and final applications are accurate and complete in the credentialing database.

　　Updates database on an ongoing basis as necessary.

　　FINANCE ESSENTIAL FUNCTIONS

　　Assists with financial management tasks such as dues, fees, and/or payments.GROWTH/INNOVATION ESSENTIAL FUNCTIONS

　　Participates in department projects and activities.This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

　　EDUCATION

　　High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)WORK EXPERIENCE

　　Three years of experience in the Medical Staff Credentialing / Privileging function in a hospital setting, with regular interaction and communication with medical staff and hospital leadership.

　　Three years of experience in word-processing and spreadsheet software such as Microsoft Word and Excel. Experience with credentialing software preferred.

　　LICENSES AND CERTIFICATIONS - REQUIRED

　　N/ALICENSES AND CERTIFICATIONS - PREFERRED

　　CPMSM - Certified Professional Medical Services Management (NAMSS) or

　　CPCS - Certified Provider Credentialing Specialist (NAMSS)

　　KNOWLEDGE, SKILLS, AND ABILITIES

　　Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations.

　　Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security.

　　Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles.

　　Self-motivated, detail-oriented, energetic, and able to prioritize multiple projects.

　　Knowledge of accreditation standards that relate to Medical Staff Services.

　　Computer literacy, including ability to utilize various software programs to complete all job tasks described in job summary. Must be proficient in word-processing and spreadsheet software such as Microsoft Word and Excel. Knowledge of credentialing software preferred.

　　General knowledge of medical terminology.

　　Ability to complete work within designated time frames.

　　Ability to offer suggestions and implement change to enhance efficiency and organization of office operations.

　　Ability to maintain confidentiality and privacy of practitioner files.

　　SUPPLEMENTAL REQUIREMENTS

　　WORK ATTIRE

　　Uniform No

　　Scrubs No

　　Business professional Yes

　　Other (department approved) No

　　ON-CALL*

　　*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

　　On Call* NoTRAVEL

　　Travel specifications may vary by department

　　May require travel within the Houston Metropolitan area Yes

　　May require travel outside Houston Metropolitan area No

　　Company Profile:

　　Houston Methodist is one of the nation’s leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston area. Houston Methodist also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, Houston Methodist employs more than 27,000 employees and is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care.

　　Houston Methodist is an equal opportunity employer inclusive of women, minorities, disabled persons and veterans.

　　Equal Employment Opportunity

　　Houston Methodist is an Equal Opportunity Employer.

　　Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.

　　Houston Methodist is an Equal Opportunity Employer.

　　Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.