Credentialing Specialist

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Dallas, TX US
Job ID:
Area of Interest:
Job Type:
Full Time
Texas Health Organization for Physicians

Texas Health Organization for Physicians is seeking a Credentialing Specialist.

Location and Hours:
Dallas - North Point Corporate Office located on LBJ Freeway
Monday-Friday 8am-5pm

High School Diploma or equivalent required
Bachelor's degree preferred

Two years of credentialing coordination experience in Healthcare (specifically, physician practice), managed care, and/or insurance management, etc.

Certified Provider Credentialing Specialist (CPCS) preferred, not required

Skills and Abilities:
Experience with new installations and integrations of physician practices. Effective business acumen to develop positive relationships and strategies to perform effectively within the dynamics of a corporate organization. Familiar with NCQA standards and how to apply them. Incumbent must have extremely effective and polished communications skills - both written and oral. Must have the capacity and availability to coordinate activities within physicians' schedules.  Ability to work independently and prioritize work, perform thorough investigation and follow through on issue resolution with minimal management intervention in a high pace environment. Proficient in the use of Excel, Word, and Powerpoint, Cognos, and Cactus (or alternate credentialing software) with basic computer and keyboarding skills.

Essential Functions:
Initial notification of new hire providers - application creation process.
Receipt of credentialing application - preparing for delegation
Special projects/other duties as assigned.

Prepare Provider Files for Credentials Committee. Experience with NCQA and Primary Source Verifications. Familiar with all aspects of physician licensure and board certification.  Support Delegated Credentialing Coordinator with all aspects of Provider File Maintenance and Health Plan reporting and auditing.

Entity Information:
Texas Health Organization for Physicians (THOP) is Texas Health Resources' 501(a) not-for-profit health corporation offering employment opportunities for administration staff that service providers of Texas Health Physicians Group (THPG). THOP provides services for member physicians that help them get back to what they do best -- practice medicine. From an affordable electronic medical record to comprehensive practice support services and group purchasing power, physicians and their patients benefit from being a part of THPG.
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-Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. LEARN MORE

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