Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Credentialing Specialist

Expired Job

Hire Up Staffing Services Bakersfield , CA 93312

Posted 2 months ago

Hire Up Staffing is currently recruiting for a Credentialing Specialist here in Bakersfield!

The ideal candidate must have previous experience!

Summary

Initiate, coordinate, monitor and maintain the credentialing and re-credentialing of all practitioners and staff employed and/or contracted with the company.

Essential Functions:

Is responsible for preparation of materials and files for presentation and review by credentialing committee.
Functional Skills

  • Ensures compliance w/ Joint Commission, NCQA standards and other regulatory agencies. Assists in the development of policies and procedures to support the credentialing process
    Collaborates w/ inter-departmental peers, including Quality Management and Operations to identify and implement best practices and to ensure an integrated, timely, and consistent product.
    Initiates and conducts primary source verification of practitioner' s background, education/training and malpractice history through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides, rosters and reports.
    Works with Human Resources/Operations Department/Provider Recruitment to ensure timely credentialing of new physicians prior to employment.
    Is able to work independently.
    Must have problem solving skills
    Excellent organizational skills
    Technical Skills

  • Responsible for the accuracy and integrity of the credentialing database. Able to run database queries and reports to support efficiencies and prioritization of work flow

Qualifications:

Any combination equivalent to: An associate s degree AND one year of credentialing experience in a managed care setting or experience in the medical field with a thorough understanding of credentialing and privileging. Background of strong administrative skills will also be considered.
Proven ability to function independently w/ minimal direct supervision required.
Strong organizational and communication skills required.
Excellent oral and written communication, interpersonal and computer skills required.
Proficient in Microsoft Office Suite
Extracting and formatting data for ad HOC report requests.
Attention to detail a must.
Confidentiality required.
Knowledge of MD Staff (ASM) preferred.
Significant working knowledge of accreditation standards, including Joint Commission, NCQA and CMS preferred.
Certification as Certified Provider Credentialing Special (CPCS) desired.

If you meet all of the requirements and would like to be considered, please email your resume to:

I am looking to interview and place as soon as possible.


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Credentialing Coordinator

Dignity Health

Posted 2 months ago

VIEW JOBS 10/18/2018 12:00:00 AM 2019-01-16T00:00 Overview The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave. Responsibilities Assist with all credentialing activities associated with all IPAs and product lines managed by MCS. Works with Credentialing Supervisor, Medical Directors, Provider Relations Department, Contracting Department, health plans, providers, provider office staff, and other persons or businesses as necessary to ensure that all providers are properly credentialed according to NCQA and health plan standards. Where appropriate, makes recommendations regarding improvement of processes and procedures. Qualifications Strong written and verbal communication skills, excellent organizational skills, and competency in Microsoft Word, Excel, and Microsoft Outlook. Self-directed and able to work independently under tight time frames. Able to interact with co-workers, managers, supervisors, and administrators in a manner that promotes a positive work environment. * Responsible for meeting all of the DHMSO Job Standards described below. * Keep current on all NCQA and health plan credentialing standards, policies, and procedures. * Maintain access to all Primary Source Verification websites. * Assists with performing internal primary source verifications and full credentialing for those providers who are to be credentialed on a RUSH RUSH status is to be determined by administration including CEO and Medical Directors. * Keep all credentialing files and credentialing database current and complete. * Attend assigned meetings pertaining to provider credentialing and provider network management as assigned, including but not limited to Provider Information Meetings sponsored by Provider Relations Department on a quarterly basis, QM & Credentialing Committee meeting for GEMCare Medical Group, and MasterCare IPA Board of Directors. Dignity Health Bakersfield CA

Credentialing Specialist

Expired Job

Hire Up Staffing Services