Description

Exalt Health Rehabilitation Hospitals is a leading provider of specialized rehabilitation services dedicated to restoring hope and function to individuals recovering from illness or injury. With a network of hospitals across Texas, Arizona, and Florida, we are committed to delivering exceptional patient care through an interdisciplinary approach, evidence-based practices, and a focus on positive outcomes.

Position Summary

The Medical Staff Credentialing Coordinator is a vital member of the Compliance team, responsible for the meticulous preparation, submission, and ongoing maintenance of enrollment, credentialing, and re-credentialing documentation for physicians and all other licensed healthcare providers at Exalt Health Rehabilitation Hospital. This role ensures that our providers meet all regulatory, legal, and internal requirements, safeguarding patient safety and maintaining the hospital's high standards of care.

Essential Duties and Responsibilities

• Provider Data Management: Compiles, maintains, and ensures the accuracy of all provider data within credentialing databases and systems (e.g., CredentialStream, NPDB, CAQH). Performs routine data entry and system updates.
• Primary Source Verification: Conducts all levels of primary source verification for provider credentials, including but not limited to state licensure, DEA registration, and board certifications.
• Application Processing: Manages the end-to-end process for initial and re-credentialing/privileging applications. Audits all applications to guarantee accuracy and completeness before submission.
• Regulatory Compliance: Handles requests for revalidation and ensures all credentialing activities adhere to organizational policies and accreditation standards.
• Committee Submission & Follow-Up: Prepares and submits completed credentialing files and supporting documentation to the hospital's Medical Staff and Governing Body for review and approval. Diligently monitors application progress, following up with providers and internal stakeholders as needed until active medical staff status is confirmed.
• Document & Expiration Tracking: Maintains organized digital and physical copies of current state licenses, DEA certificates, malpractice insurance coverage, and all other required credentialing documents. Proactively tracks all expiration dates to ensure timely renewals and prevent any lapse in privileges.
• Continuing Medical Education (CME) Tracking: Monitors provider CME credits and sends monthly or quarterly updates to ensure compliance with state and board requirements.
• Research & Investigation: Utilizes strong research skills to gather and verify all pertinent background information regarding providers.
• Performs all other duties as assigned to support the Compliance department and hospital operations.

Requirements

Minimum Qualifications

(Knowledge, Skills, and Abilities)

Licenses or Certifications

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) certification is required.

Education, Training, and Experience

• High School Diploma or equivalent is required.
• A minimum of 3-5 years of direct experience in a healthcare credentialing role is required.
• An equivalent combination of relevant education and professional work experience will be considered.

Skills and Abilities, Proficiency and Productivity Standards

• Meticulous and conscientious with an exceptional eye for detail and accuracy.
• Deep working knowledge of credentialing processes, accreditation regulations (e.g., CHIQ, NCQA), and relevant healthcare policies and procedures.
• Experience and a working knowledge of the CredentialStream platform is strongly preferred
• Excellent interpersonal skills with the ability to communicate effectively and professionally in both verbal and written forms.
• Demonstrated ability to handle confidential information with the highest degree of trust, integrity, and discretion.
• Strong analytical, organizational, and time-management skills; adept at prioritizing tasks and managing deadlines in a fast-paced environment.
• Proficient computer skills, including expert-level knowledge of Microsoft Office Suite (Word, Excel, Outlook) and experience with credentialing software.
• A proactive, independent worker who can assume responsibility for tasks with minimal supervision.
• Ability to relate to and communicate effectively with people from diverse cultural backgrounds

Exalt Health is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.