- Direct Placement
- Long Beach, CA
The Credentialing Specialist supports the Credentialing Department by performing all duties related to credentialing and re-credentialing. The position works under the Supervision of the Department Manager.
- Coordinate maintain and monitor Credentialing management database.
- Update Payer Credentialing Applications and different credentialing forms.
- Create and Maintain Provider CAQH Profiles
- Assist providers to become contracted with different payers, including Medicare, Medical, PPO's and HMO's.
- Assist providers to obtain hospital privileges
- Maintain Payer Credentialing Forms. Undertake periodic audits of all forms for accuracy and changes, as well as Payer Process flow.
- Help to develop and design innovative tools, features and workflows to improve credentialing.
- Coordinate with the payers to ensure that all credentialing requirements are met.
- Follow-up on submitted applications with payers and/or practice/client.
- Proper Implementation, maintenance and continuous improvement of Quality Control, Audit and Productivity of the specified area of responsibility.
- Assist with On-boarding of new clients and related duties as assigned.
- Assist with Off boarding leaving clients and related duties as assigned.
- Provide regular feedback to client/physicians and management regarding the status with their credentialing.
- Assist in training staff when needed it.
- Perform other various related duties and assists with special projects as assigned.
- Reports any compliance areas of concern to Department Manager.
- Minimum of (1) to (2) years of credentialing experience required.
- High School diploma
- Excellent analytical, organization and time management skills.
- Ability to exercise a high level of tact and discretion in both, internal and external interactions.
- Excellent written and verbal communications skills
- Positive communicator and Team player
- Problem solving and critical thinking
- Must have credentialing knowledge and familiarity with industry recognized standards.
- Proficient in office communication systems (e-mail programs), MS Word, MS Excel, MS PowerPoint.
- Experience with IntelliCred credentialing system a plus.
- Must be confident, creative and self-motivated and enthusiastic
$19.00 – $24.03
Monday – Friday 8:00 – 5:00
Direct Hire – Full Benefits