Title:  Senior Coordinator, Provider Support Services

Division:  Baylor MedCare
Schedule:  Monday to Friday 8 a.m. to 5 p.m.
Work Location:  Houston, TX
Salary Range:  $46,176 to $63,723
FLSA Status:  Nonexempt
Requisition ID:  12453

Summary

Performs credentialing activities to ensure the integrity and quality of practitioner credentialing and practice data. Conducts thorough background investigations and compiles profiles for practitioners applying for appointment/reappointment to BaylorMedCare. Processes applications and performs data entry timely, accurately and in compliance with BaylorMedCare and National Committee for Quality Assurance (NCQA) standards. Performs these and other functions as necessary to meet departmental goals with only general supervision.

 

This position requires knowledge of manage care practitioner credentialing which include verification for State medical license, education, board certification, hospital affiliations, work history, Nation Practitioner Data Bank Query, other State and Federal sanction background queries, Professional references, malpractice claims history and  be familiar with the Texas Standard Credentialing Application and questions regarding inability to practice, illegal drug use, loss of license, felony conviction, loss or limited privileges. 

Job Duties

  • Works with BCM Clinical Departments to identify practitioners and facilitate the Texas Standard Credentialing application process.
  • Applies independent decision-making to review and analyze physician applications and credentials for completeness and accuracy.
  • Performs background checks by contacting numerous primary sources. Contacts by written, verbal, or electronic means.
  • Maintains a system for follow-up of unanswered correspondence according to the schedules designed to maintain department standards for application processing time.
  • Compiles thorough practitioner profiles and prepares data for Committee review.
  • Maintains electronic and paper credentials files according to department standards.
  • Assists in the coordination of payer audits. Supplies auditors with data and other information to ensure department compliance with MCO standards.
  • Works cooperatively with team members to meet department goals and objectives with only general supervision.
  • Understands and complies with NCQA Standards as applicable to the Credentialing and related functions.
  • Understands and complies with BaylorMedCare Policies and Procedures.

Minimum Qualifications

  • High school diploma or GED.
  • Four years of relevant experience.

Preferred Qualifications

  • Three years progressive responsibility within a healthcare administration environment. 
  • Practitioner credentialing and managed care experience. Exceptional written and verbal communication skills. 
  • Expertise in Practitioner Credentialing Files.
  • Strong interpersonal skills. 
  • Excellent problem-solving ability.
  • Excellent organizational skills.
  • Understands and complies with NCQA Standards as applicable to the Credentialing and related functions.

Hiring Criteria

Marissa Brinkman may be an identified candidate.

Looking for someone with previous credentialing experience who can manage a workload of 60 files at any given time.  There three other coordinators.  Work load is detailed and fast paced.  Must be able to handle high volume work.

 

 

Baylor College of Medicine requires employees to be fully vaccinated -subject to approved exemptions-against vaccine-preventable diseases including, but not limited to, COVID-19 and influenza.

 

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.

 12453

CA