IMCS Group · 3 months ago
Temp - Administrative - Credentialing Specialist (Days) Dallas, TX
Dallas, TX
Full-time
Onsite
New Grad, Entry LevelIMCS Group is seeking a Credentialing Specialist to support Parkland Community Health Plan’s credentialing program. The role involves evaluating practitioners and facilities, conducting ongoing reviews, and analyzing provider data to ensure compliance with regulatory requirements.
Staffing & Recruiting
Responsibilities
Builds and maintains relationships with external vendors and credentialing partners including Aperture & Texas Association of Health Plans
Administrates reports in external database portals & analyze data, confirm accuracy, and present to internal department
Assists with the oversight of the delegated and non-delegated provider and facility’s data
Gathers, analyzes, and reports provider data to internal and external customers
Ensures that all practitioners and facilities are evaluated upon entry into the PCHP network and conducts an ongoing review of the providers
Identifies opportunities for improvement through the audit process and provide recommendations
Accurately tracks, reports, and follows up on the status of credentialing applications
Maintains a strict degree of confidentiality in all areas relating to provider credentials, status and provider personal information
Familiar with state specific all credentialing department policies and procedures
Assist with miscellaneous audits projects throughout the year as required
Communicates with Credentialing Manager regarding any or all credentialing delays or issues
Other duties as assigned
Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP
Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding
Qualification
Required
Access to high-speed internet and secure working environment is required
Applicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera
Builds and maintains relationships with external vendors and credentialing partners including Aperture & Texas Association of Health Plans
Administrates reports in external database portals & analyze data, confirm accuracy, and present to internal department
Assists with the oversight of the delegated and non-delegated provider and facility's data
Gathers, analyzes, and reports provider data to internal and external customers
Ensures that all practitioners and facilities are evaluated upon entry into the PCHP network and conducts an ongoing review of the providers
Identifies opportunities for improvement through the audit process and provide recommendations
Accurately tracks, reports, and follows up on the status of credentialing applications
Maintains a strict degree of confidentiality in all areas relating to provider credentials, status and provider personal information
Familiar with state specific all credentialing department policies and procedures
Assist with miscellaneous audits projects throughout the year as required
Communicates with Credentialing Manager regarding any or all credentialing delays or issues
Identifies ways to improve work processes and improve customer satisfaction
Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area
Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements
Seeks advice and guidance as needed to ensure proper understanding
Advanced proficiency in Microsoft Excel to include Vlookup, creating complex function and equations
Strong interpersonal, problem solving and relationship building skills with positive attitude and demeanor
Ability to take initiative to research and form conclusions independently
Ability to manage multiple deadlines and time constraints in a fast-paced environment
Demonstrated ability to collaborate effectively and work as part of a team including internal and external stakeholders
Ability to perform detail work efficiently and with a high degree of accuracy
Clear and professional verbal and written communication skills with the ability to clearly explain complex processes
Skilled in interpreting, analyzing, and providing recommendations regarding data accuracy and data collection needs and processes
Excellent planning, organization, time management, and documentation skills
Preferred
Local candidates preferred; ***/hr rate within *** miles
Non local candidates; ***/hr rate outside of 35 miles and would be considered fully remote
Company
IMCS Group
IMCS Group is an IT, Healthcare, and Professional Staffing Company that helps Enterprises optimize the business value of their Staffing investments and enables them to achieve world-class business performance.
Founded in 2002
201-500 employees
H1B Sponsorship
IMCS Group has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (16)
2023 (33)
2022 (32)
2021 (47)
2020 (82)
Funding
Current Stage
Growth StageLeadership Team
Satish G Kumar
Founder and CEO
Kathleen Thompson
Diretor Client Partnership
Company data provided by crunchbase