Overview
St. Luke’s Health is the largest Catholic health system in greater Houston and southeast Texas. Our integrated delivery network comprises sixteen hospitals covering Houston, Brazos Valley, southeast Texas and Lake Jackson, and East Texas and Lufkin, and includes Baylor St. Luke’s Medical Center, the research and teaching hospital for Baylor College of Medicine. St. Luke’s Health is home to the Texas Heart ®Institute (THI), the top ranked heart center in Houston, and the Dan L Duncan Comprehensive Cancer Center, a nationally ranked NCI designated cancer center. Our integrated network of care includes more than 398 employed and 1,668 clinically aligned network providers, and more than 20,000 employees delivering high value, nationally ranked quality and compassionate care along with our Christian ministry of healing. Our goal is to deliver accessible, nationally recognized high quality care through the highest value network for choice in healthcare for patients, employers and payers with a commitment to an equitable and personalized patient experience for all consistent with our ministry of healing.
Responsibilities
The Credentialing Coordinator will coordinate the credentialing activities at the Division level including data entry and physician database maintenance; credentialing processes, expirables and other duties that support provider onboarding activities. Serves as effective liaison between provider and the facilities throughout the credentialing process. Responsible for understanding State and Federal Regulatory Agencies requirements, accreditation compliance and other critical matters that affect the healthcare environment as it relates to the credentialing process. Performs other duties as assigned in an effective competent manner.
POSITION RESPONSIBILITIES
- Initiates and coordinates the collection of primary source information for credentialing purposes at the division level. Verifies, compiles, manages and maintains confidential research required for credentialing of initial appointment and reappointment applicants. Processes applications according to established legal, State and Federal agencies, State licensing board, regulatory and facility standards. Coordinates, tracks, and monitors flow of information to ensure the timely processing and notification of applicants in accordance with the guidelines established.
- Conducts thorough analysis of all primary source documentation received for assessment of qualifications/competencies. Assures appropriate education and training including procedural documentation has been provided to support clinical privileges requested. Identifies any potential quality of care issues, behavioral problems, and/or other issues, escalating as necessary. Summarizes and prepares credentialing information, including information about flagged concerns, for review and decisions. Applies the credentials evaluation process uniformly to all initial appointment and reappointment applications to ensure compliance with St. Luke’s Health credentialing policies, procedures and applicable Medical Staff Bylaws. Compiles information regarding CME credits and other requirements in accordance with state licensing requirements and Division policy.
- Facilitates review and assessment of documentation for each application. Serves as the Central Verification Office (CVO) primary point of contact for practitioners during appointment and reappointment process. Must be available to guide practitioners through the process and clearly communicate requirements.
- Maintains an accurate, secure and current database of physician and advanced practitioner/allied health professional information. Proficient with MSOW, Cactus or similar credentialing platform. Follows data entry policy.
- Appropriately escalates concerns regarding credentialing documents and/or timeliness of the verification process. Communicates with facilities appropriately and in a timely manner according to policy. Maintains confidentiality.
- Monitors and maintains all required expirables.
- Provides clerical support including filing, routing mail, scheduling and attending meetings, generating reports as required.
- Supports system and division standardization efforts. Participates in identifying and implementing best practices.
Qualifications
MINIMUM QUALIFICATIONS
Experience – Minimum of one (1) year of experience in medical staff services, hospital administrative department or credentialing verification organization. Comparable healthcare or managed care work experience may be considered.
Education – High School diploma
Licensure/Certification – None required
Minimum Knowledge, Skills, and Abilities:
- Credentialing database experience, MSOW or Cactus preferred
- Proficiency in Microsoft Office and/or Google Workspace
- Excellent written and oral communication skills
- Excellent data entry skills; detail-oriented, ability to prioritize tasks
- Ability to work remotely while maintaining confidentiality, communicating appropriately and completing assignments according to deadlines
- Ability to comprehend and follow instructions; maintain attention and concentration for necessary periods.
- Ability to synthesize, coordinate, and analyze data, perform simple and repetitive tasks and maintain a work pace appropriate to given workload.
- Perform varied tasks; relate to other people beyond giving and receiving instructions in stressful situations, get along well with customers, co-workers and peers;
- Understand the meaning of words and how to use them appropriately and effectively; make appropriate decisions or exercise judgement based on appropriate information while elevating questions and concerns to the supervisor.
- Accept and carry out responsibility for direction, control and planning of day-to-day workload
DISCLOSURE STATEMENT:
The above statements reflect the general details considered necessary to describe the essential functions of the job as identified, and shall not be considered a detailed description of all work requirements that may be inherent in position.
Pay Range$20.71 - $28.48 /hour